A cohort study of 49 933 women with surgically verified endometriosis - increased incidence of breast cancer below the age of 40

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Abstract Introduction The association between endometriosis and breast cancer is unclear. We assessed the risk of breast cancer in women with surgically verified endometriosis, with special focus on the age at cancer diagnosis, time from endometriosis diagnosis and breast cancer histology. Material and Methods All women with first endometriosis associated diagnoses occurring concomitantly with relevant surgical codes during 1987-2012 were retrieved from the Finnish Hospital Discharge Register in Finland. Breast cancers diagnosed after the endometriosis diagnosis were identified from the Finnish Cancer Registry. The Finnish female population served as the reference. The endometriosis cohort consisted of 49 933 women (23 210 cases of ovarian, 20 187 peritoneal and 2372 deep infiltrating endometriosis). The outcome measure was the standardized incidence ratio (SIR) with 95% confidence interval (95%CI) of breast cancer calculated for the whole cohort and for the subtypes of endometriosis, stratified by the age at breast cancer diagnosis, histology, and time from endometriosis diagnosis. Results The overall risk of breast cancer (1555 cases) was similar to the reference population (SIR 0.99; 95%CI 0.94 to 1.03), did not differ in types of endometriosis, and was similar for ductal and lobular breast cancer. However, the SIR of breast cancer was increased in the age group of 20-29 years (4.44; 95%CI 2.22 to 7.94), and in the age group of 30-39 years (1.28; 1.03 to 1.57). The risk of in situ breast cancer (170 cases) was increased in the entire endometriosis cohort (1.25; 1.07-1.44). Conclusions The overall risk of breast cancer in women with surgically verified endometriosis was similar to that of general population. However, the risk of breast cancer at young age was increased. Young women with surgically verified endometriosis represent highly symptomatic patients with more frequent surgeries and additional therapies that might also contribute to the risk of breast cancer. This article is protected by copyright. All rights reserved.
Originalspråkengelska
TidskriftActa Obstetricia et Gynecologica Scandinavica
Volym0
Utgåvaja
ISSN0001-6349
DOI
StatusPublicerad - 18 mar 2019
MoE-publikationstypA1 Tidskriftsartikel-refererad

Vetenskapsgrenar

  • 3123 Kvinno- och barnsjukdomar

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@article{ecb348d50e0a4198af81d067c26cc554,
title = "A cohort study of 49 933 women with surgically verified endometriosis - increased incidence of breast cancer below the age of 40",
abstract = "Abstract Introduction The association between endometriosis and breast cancer is unclear. We assessed the risk of breast cancer in women with surgically verified endometriosis, with special focus on the age at cancer diagnosis, time from endometriosis diagnosis and breast cancer histology. Material and Methods All women with first endometriosis associated diagnoses occurring concomitantly with relevant surgical codes during 1987-2012 were retrieved from the Finnish Hospital Discharge Register in Finland. Breast cancers diagnosed after the endometriosis diagnosis were identified from the Finnish Cancer Registry. The Finnish female population served as the reference. The endometriosis cohort consisted of 49 933 women (23 210 cases of ovarian, 20 187 peritoneal and 2372 deep infiltrating endometriosis). The outcome measure was the standardized incidence ratio (SIR) with 95{\%} confidence interval (95{\%}CI) of breast cancer calculated for the whole cohort and for the subtypes of endometriosis, stratified by the age at breast cancer diagnosis, histology, and time from endometriosis diagnosis. Results The overall risk of breast cancer (1555 cases) was similar to the reference population (SIR 0.99; 95{\%}CI 0.94 to 1.03), did not differ in types of endometriosis, and was similar for ductal and lobular breast cancer. However, the SIR of breast cancer was increased in the age group of 20-29 years (4.44; 95{\%}CI 2.22 to 7.94), and in the age group of 30-39 years (1.28; 1.03 to 1.57). The risk of in situ breast cancer (170 cases) was increased in the entire endometriosis cohort (1.25; 1.07-1.44). Conclusions The overall risk of breast cancer in women with surgically verified endometriosis was similar to that of general population. However, the risk of breast cancer at young age was increased. Young women with surgically verified endometriosis represent highly symptomatic patients with more frequent surgeries and additional therapies that might also contribute to the risk of breast cancer. This article is protected by copyright. All rights reserved.",
keywords = "Breast cancer, endometriosis, ovarian endometriosis, peritoneal endometriosis, deep infiltrating endometriosis, 3123 Gynaecology and paediatrics",
author = "Liisu Saavalainen and Heini Lassus and Anna But and Aila Tiitinen and P{\"a}ivi H{\"a}rkki and Mika Gissler and Eero Pukkala and Oskari Heikinheimo",
year = "2019",
month = "3",
day = "18",
doi = "10.1111/aogs.13609",
language = "English",
volume = "0",
journal = "Acta Obstetricia et Gynecologica Scandinavica",
issn = "0001-6349",
publisher = "Wiley",
number = "ja",

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TY - JOUR

T1 - A cohort study of 49 933 women with surgically verified endometriosis - increased incidence of breast cancer below the age of 40

AU - Saavalainen, Liisu

AU - Lassus, Heini

AU - But, Anna

AU - Tiitinen, Aila

AU - Härkki, Päivi

AU - Gissler, Mika

AU - Pukkala, Eero

AU - Heikinheimo, Oskari

PY - 2019/3/18

Y1 - 2019/3/18

N2 - Abstract Introduction The association between endometriosis and breast cancer is unclear. We assessed the risk of breast cancer in women with surgically verified endometriosis, with special focus on the age at cancer diagnosis, time from endometriosis diagnosis and breast cancer histology. Material and Methods All women with first endometriosis associated diagnoses occurring concomitantly with relevant surgical codes during 1987-2012 were retrieved from the Finnish Hospital Discharge Register in Finland. Breast cancers diagnosed after the endometriosis diagnosis were identified from the Finnish Cancer Registry. The Finnish female population served as the reference. The endometriosis cohort consisted of 49 933 women (23 210 cases of ovarian, 20 187 peritoneal and 2372 deep infiltrating endometriosis). The outcome measure was the standardized incidence ratio (SIR) with 95% confidence interval (95%CI) of breast cancer calculated for the whole cohort and for the subtypes of endometriosis, stratified by the age at breast cancer diagnosis, histology, and time from endometriosis diagnosis. Results The overall risk of breast cancer (1555 cases) was similar to the reference population (SIR 0.99; 95%CI 0.94 to 1.03), did not differ in types of endometriosis, and was similar for ductal and lobular breast cancer. However, the SIR of breast cancer was increased in the age group of 20-29 years (4.44; 95%CI 2.22 to 7.94), and in the age group of 30-39 years (1.28; 1.03 to 1.57). The risk of in situ breast cancer (170 cases) was increased in the entire endometriosis cohort (1.25; 1.07-1.44). Conclusions The overall risk of breast cancer in women with surgically verified endometriosis was similar to that of general population. However, the risk of breast cancer at young age was increased. Young women with surgically verified endometriosis represent highly symptomatic patients with more frequent surgeries and additional therapies that might also contribute to the risk of breast cancer. This article is protected by copyright. All rights reserved.

AB - Abstract Introduction The association between endometriosis and breast cancer is unclear. We assessed the risk of breast cancer in women with surgically verified endometriosis, with special focus on the age at cancer diagnosis, time from endometriosis diagnosis and breast cancer histology. Material and Methods All women with first endometriosis associated diagnoses occurring concomitantly with relevant surgical codes during 1987-2012 were retrieved from the Finnish Hospital Discharge Register in Finland. Breast cancers diagnosed after the endometriosis diagnosis were identified from the Finnish Cancer Registry. The Finnish female population served as the reference. The endometriosis cohort consisted of 49 933 women (23 210 cases of ovarian, 20 187 peritoneal and 2372 deep infiltrating endometriosis). The outcome measure was the standardized incidence ratio (SIR) with 95% confidence interval (95%CI) of breast cancer calculated for the whole cohort and for the subtypes of endometriosis, stratified by the age at breast cancer diagnosis, histology, and time from endometriosis diagnosis. Results The overall risk of breast cancer (1555 cases) was similar to the reference population (SIR 0.99; 95%CI 0.94 to 1.03), did not differ in types of endometriosis, and was similar for ductal and lobular breast cancer. However, the SIR of breast cancer was increased in the age group of 20-29 years (4.44; 95%CI 2.22 to 7.94), and in the age group of 30-39 years (1.28; 1.03 to 1.57). The risk of in situ breast cancer (170 cases) was increased in the entire endometriosis cohort (1.25; 1.07-1.44). Conclusions The overall risk of breast cancer in women with surgically verified endometriosis was similar to that of general population. However, the risk of breast cancer at young age was increased. Young women with surgically verified endometriosis represent highly symptomatic patients with more frequent surgeries and additional therapies that might also contribute to the risk of breast cancer. This article is protected by copyright. All rights reserved.

KW - Breast cancer

KW - endometriosis

KW - ovarian endometriosis

KW - peritoneal endometriosis

KW - deep infiltrating endometriosis

KW - 3123 Gynaecology and paediatrics

U2 - 10.1111/aogs.13609

DO - 10.1111/aogs.13609

M3 - Article

VL - 0

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

SN - 0001-6349

IS - ja

ER -