한빛사 논문
Danbee Kang1,2,9, Sang Eun Yoon3,9, Dongwook Shin1,4, Jin Lee1,2, Yun Soo Hong5, Se Kyung Lee6, Jeong Eon Lee6, Yeon Hee Park3, Jin Seok Ahn3, Eliseo Guallar2,5, Won Seog Kim3,7, Jungho Lee8, Seok Jin Kim3,7,* and Juhee Cho1,2,5,*
1Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea. 2Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea. 3Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 4Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 5Department of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. 6Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 7Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea. 8Department of Plastic Surgery, The Catholic University of Korea, Bucheon ST. Mary’s Hospital, Bucheon, South Korea. 9These authors contributed equally: Danbee Kang, Sang Eun Yoon.
*Correspondence to Seok Jin Kim or Juhee Cho.
Abstract
Several studies have suggested that estrogens have a protective function against lymphomagenesis. The treatment of breast cancer is driven by subtype classification, and the assessment of hormone receptor status is important for treatment selection. Thus, we evaluated the association between breast cancer and the incidence of NHL. We conducted a retrospective cohort study using a population-based nationwide registry in South Korea. We selected all women with newly diagnosed breast cancer between January 1st, 2002 and December 31st, 2016 who received curative treatment (N = 84,969) and a 1:10 sample of age-matched non-breast cancer controls (N = 1,057,674). Incident breast cancer (time-varying exposure) was the exposure and development of any type of NHL, including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), mature T/NK-cell lymphomas, anaplastic large cell lymphoma (ALCL), and unspecified types of NHL, was the outcome. During follow-up, 1564 incident cases of NHL occurred. The fully adjusted Hazard Ratio (HR) for NHL associated with the development of breast cancer was 1.64 (95% CI = 1.34–2.00) after adjusting for body mass index, alcohol intake, physical activity, smoking, income, and comorbidity. The adjusted HR for NHL was much higher in participants who were aged <50 years and who received hormone therapy (either tamoxifen or aromatase inhibitors) than in those ≥50 years or who did not receive hormone therapy, respectively. The development of breast cancer was associated with a significantly increased risk of NHL, particularly follicular lymphoma and mature T/NK-cell lymphoma. In particular, the risk of NHL was higher in patients receiving hormone therapy and in younger patients.
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