title: Prior breast cancer and tamoxifen exposure does not influence outcomes in women with uterine papillary serous carcinoma.
abstract: To evaluate progression-free survival (PFS) and overall survival (OS) outcomes in women diagnosed with uterine papillary serous carcinoma (UPSC) who have had (UPSCBR+) or have not had (UPSCBR-) an antecedent history of breast cancer and to correlate their outcomes to prior tamoxifen exposure.
  
  
  
  Data were collected for women diagnosed with UPSC at two academic institutions between January 1997 and July 2012. Patient demographics, tumor histology, stage, and treatments were recorded. Patients were divided into two groups: those with and without a personal history of breast cancer. Within the UPSCBR+ cohort, we identified those with a history of tamoxifen use. Cox regression modeling was used to explore associations between selected covariates of interest and the time-to-event outcomes of PFS and OS.
  
  
  
  Of 323 patients with UPSC, 46 (14%) were UPSCBR+. Of these, 15 (33%) had a history of tamoxifen use. UPSCBR+ patients were older than UPSCBR- (median years, 72 vs. 68, p=0.004). UPSCBR+ women showed no significant difference in PFS or OS compared to UPSCBR- (p=0.64 and p=0.73 respectively), even after controlling for age (p=0.15 and p=0.48 respectively). Within the UPSCBR+ cohort, there was no difference in PFS or OS with or without tamoxifen exposure (p=0.98 and p=0.94 respectively).
  
  
  
  There was no difference in PFS or OS between the UPSCBR+ and UPSCBR- cohorts. We did not demonstrate significant OS or PFS differences in women who took tamoxifen prior to their endometrial cancer diagnosis. These findings have implications for counseling, and should be encouraging to women who are facing their second cancer diagnosis.
authors.affiliation: University of North Carolina, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States. Electronic address: Stuart.Pierce@unchealth.unc.edu.
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Pierce
authors.affiliation: University of North Carolina, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States.
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Stine
authors.affiliation: University of North Carolina, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States; Lineberger Clinical Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Paola A
authors.initials: PA
authors.lastname: Gehrig
authors.affiliation: Duke University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Durham, NC, United States.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Havrilesky
authors.affiliation: Duke University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Durham, NC, United States.
authors.forename: Angeles A
authors.initials: AA
authors.lastname: Secord
authors.affiliation: Duke University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Durham, NC, United States.
authors.forename: John
authors.initials: J
authors.lastname: Nakayama
authors.affiliation: Lineberger Clinical Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Snavely
authors.affiliation: Lineberger Clinical Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Dominic T
authors.initials: DT
authors.lastname: Moore
authors.affiliation: University of North Carolina, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States; Lineberger Clinical Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Kim
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D018283:Cystadenocarcinoma, Papillary / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D018284:Cystadenocarcinoma, Serous / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D018572:Disease-Free Survival; D004965:Estrogen Antagonists / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013629:Tamoxifen / Q000008:administration & dosage*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology
chemical_list: D004965:Estrogen Antagonists; D013629:Tamoxifen
keywords: Breast cancer; Survival; Tamoxifen; Uterine papillary serous cancer