Antiestrogen use in breast cancer patients reduces the risk of subsequent lung cancer: A population-based study.
There is accumulating epidemiological and preclinical evidence that estrogen might be a driver of lung cancer. Breast cancer survivors can offer a unique patient cohort to examine the effect of antiestrogen therapy on lung cancer carcinogenesis because many of these women would have received long-term selective estrogen receptor modulators (SERMs) and/or aromatase inhibitors (AIs) as adjuvant treatment. Our hypothesis is that estrogens play a role in lung cancer development, and that antiestrogen therapy would affect the incidence of subsequent lung cancer among breast cancer survivors.



Using the Taiwan National Health Insurance (NHI) database, the study included 40,900 survivors of non-metastatic breast cancer after primary surgery, and most antiestrogen users complied well with the medication regimen. We evaluate the effect of antiestrogen therapy on the incidence of subsequent lung cancers.



This population-based study revealed that antiestrogen use in breast cancer patients was associated with a reduced risk of subsequent lung cancer in older patients (≥50 years) (HR 0.73, 95%CI 0.54-0.99) when compared with breast cancer survivors who did not use antiestrogens.



The study supports the hypothesis that antiestrogen therapy modifies lung cancer carcinogenesis in older women. Further well-designed clinical trials to explore the potential of antiestrogens in lung cancer prevention and treatment would be worthwhile.
Department of Hematology and Oncology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC; Institute of Medical Sciences, Tzu-Chi University, Hualien, Taiwan, ROC; Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan, ROC.
Sung-Chao
SC
Chu
Department of Public Health, Tzu-Chi University, Hualien, Taiwan, ROC.
Chia-Jung
CJ
Hsieh
Department of Hematology and Oncology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC; Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan, ROC.
Tso-Fu
TF
Wang
Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC; Institute of Medical Sciences, Tzu-Chi University, Hualien, Taiwan, ROC.
Mun-Kun
MK
Hong
Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC; Center for Prevention of Gynecological Cancer, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC; Institute of Medical Sciences, Tzu-Chi University, Hualien, Taiwan, ROC. Electronic address: hidrchu@gmail.com.
Tang-Yuan
TY
Chu
D000293:Adolescent; D000328:Adult; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004965:Estrogen Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D012307:Risk Factors; D013629:Tamoxifen / Q000627:therapeutic use*; D055815:Young Adult
D047072:Aromatase Inhibitors; D004965:Estrogen Antagonists; D013629:Tamoxifen
Antiestrogen; Aromatase inhibitor; Breast cancer; Lung cancer; SERMs; Tamoxifen