Disease trajectories and mortality among women diagnosed with breast cancer
Abstract Purpose Breast cancer is a common disease with a relatively good prognosis. Therefore, understanding the spectrum of diseases and mortality among breast cancer patients is important, though currently incomplete. We systematically examined the incidence and mortality of all diseases followin...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | Breast Cancer Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13058-019-1181-5 |
| _version_ | 1818457816233410560 |
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| author | Haomin Yang Yudi Pawitan Wei He Louise Eriksson Natalie Holowko Per Hall Kamila Czene |
| author_facet | Haomin Yang Yudi Pawitan Wei He Louise Eriksson Natalie Holowko Per Hall Kamila Czene |
| author_sort | Haomin Yang |
| collection | DOAJ |
| description | Abstract Purpose Breast cancer is a common disease with a relatively good prognosis. Therefore, understanding the spectrum of diseases and mortality among breast cancer patients is important, though currently incomplete. We systematically examined the incidence and mortality of all diseases following a breast cancer diagnosis, as well as the sequential association of disease occurrences (trajectories). Methods In this national cohort study, 57,501 breast cancer patients (2001–2011) were compared to 564,703 matched women from the general Swedish population and followed until 2012. The matching criteria included year of birth, county of residence, and socioeconomic status. Based on information from the Swedish Patient and Cause of Death Registries, hazard ratios (HR) were estimated for disease incidence and mortality. Conditional logistic regression models were used to identify disease trajectories among breast cancer patients. Results Among 225 diseases, 45 had HRs > 1.5 and p < 0.0002 when comparing breast cancer patients with the general population. Diseases with highest HRs included lymphedema, radiodermatitis, and neutropenia, which are side effects of surgery, radiotherapy, and chemotherapy. Other than breast cancer, the only significantly increased cause of death was other solid cancers (HR = 1.16, 95% CI = 1.08–1.24). Two main groups of disease trajectories were identified, which suggest menopausal disorders as indicators for other solid cancers, and both neutropenia and dorsalgia as diseases and symptoms preceding death due to breast cancer. Conclusions While an increased incidence of other diseases was found among breast cancer patients, increased mortality was only due to other solid cancers. Preventing death due to breast cancer should be a priority to prolong life in breast cancer patients, but closer surveillance of other solid cancers is also needed. |
| first_indexed | 2024-12-14T22:48:34Z |
| format | Article |
| id | doaj.art-0727192281b64e1aaa420db704eeff0e |
| institution | Directory Open Access Journal |
| issn | 1465-542X |
| language | English |
| last_indexed | 2024-12-14T22:48:34Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Breast Cancer Research |
| spelling | doaj.art-0727192281b64e1aaa420db704eeff0e2022-12-21T22:44:47ZengBMCBreast Cancer Research1465-542X2019-08-012111810.1186/s13058-019-1181-5Disease trajectories and mortality among women diagnosed with breast cancerHaomin Yang0Yudi Pawitan1Wei He2Louise Eriksson3Natalie Holowko4Per Hall5Kamila Czene6Department of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetDepartment of Medical Epidemiology and Biostatistics, Karolinska InstitutetAbstract Purpose Breast cancer is a common disease with a relatively good prognosis. Therefore, understanding the spectrum of diseases and mortality among breast cancer patients is important, though currently incomplete. We systematically examined the incidence and mortality of all diseases following a breast cancer diagnosis, as well as the sequential association of disease occurrences (trajectories). Methods In this national cohort study, 57,501 breast cancer patients (2001–2011) were compared to 564,703 matched women from the general Swedish population and followed until 2012. The matching criteria included year of birth, county of residence, and socioeconomic status. Based on information from the Swedish Patient and Cause of Death Registries, hazard ratios (HR) were estimated for disease incidence and mortality. Conditional logistic regression models were used to identify disease trajectories among breast cancer patients. Results Among 225 diseases, 45 had HRs > 1.5 and p < 0.0002 when comparing breast cancer patients with the general population. Diseases with highest HRs included lymphedema, radiodermatitis, and neutropenia, which are side effects of surgery, radiotherapy, and chemotherapy. Other than breast cancer, the only significantly increased cause of death was other solid cancers (HR = 1.16, 95% CI = 1.08–1.24). Two main groups of disease trajectories were identified, which suggest menopausal disorders as indicators for other solid cancers, and both neutropenia and dorsalgia as diseases and symptoms preceding death due to breast cancer. Conclusions While an increased incidence of other diseases was found among breast cancer patients, increased mortality was only due to other solid cancers. Preventing death due to breast cancer should be a priority to prolong life in breast cancer patients, but closer surveillance of other solid cancers is also needed.http://link.springer.com/article/10.1186/s13058-019-1181-5Breast cancerDisease trajectoryMortality |
| spellingShingle | Haomin Yang Yudi Pawitan Wei He Louise Eriksson Natalie Holowko Per Hall Kamila Czene Disease trajectories and mortality among women diagnosed with breast cancer Breast Cancer Research Breast cancer Disease trajectory Mortality |
| title | Disease trajectories and mortality among women diagnosed with breast cancer |
| title_full | Disease trajectories and mortality among women diagnosed with breast cancer |
| title_fullStr | Disease trajectories and mortality among women diagnosed with breast cancer |
| title_full_unstemmed | Disease trajectories and mortality among women diagnosed with breast cancer |
| title_short | Disease trajectories and mortality among women diagnosed with breast cancer |
| title_sort | disease trajectories and mortality among women diagnosed with breast cancer |
| topic | Breast cancer Disease trajectory Mortality |
| url | http://link.springer.com/article/10.1186/s13058-019-1181-5 |
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