Evidence map›Paper›PMID 37102221›Full record

ArticleCancer medicine2023

Survival in elderly patients with breast cancer with and without autoimmune disease.

Demitrios Dedousis, Annie L Zhang, Anastasia N Vassiliou, Shufen Cao, Deepthi Yammani, Ravi K Kyasaram, John P Shanahan, Melissa C Keinath, Melinda L Hsu, Pingfu Fu and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Demitrios DedousisDepartment of Internal Medicine, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.ORCID 0000-0002-2161-9465
Annie L ZhangDepartment of Internal Medicine, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
Anastasia N VassiliouCase Western Reserve University, Cleveland, Ohio, USA.
Shufen CaoDepartment of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
Deepthi YammaniCase Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
Ravi K KyasaramCase Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
John P ShanahanCase Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
Melissa C KeinathDepartment of Pathology, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
Melinda L HsuDivision of Hematology and Oncology, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
Pingfu FuDepartment of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
Afshin DowlatiDivision of Hematology and Oncology, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
Alberto J MonteroDivision of Hematology and Oncology, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.ORCID 0000-0002-8221-8120
University Hospitals Seidman Cancer Center · USCase Western Reserve University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with certain autoimmune conditions are at a reduced risk of developing breast cancer compared to the general population. Despite this, little is known about outcomes in patients with breast cancer who have a concurrent autoimmune diagnosis.

methodsThis study compared differences in outcomes between women with breast cancer who had or did not have an autoimmune diagnosis. The SEER-Medicare databases (2007-2014) were used to identify patients with breast cancer and diagnosis codes were used to identify those with an autoimmune disorder.

resultsThe studied autoimmune diseases had a prevalence of 27% among the 137,324 patients with breast cancer. Autoimmune disease was associated with significantly longer overall survival (OS) and significantly lower cancer-specific mortality (CSM) among stage IV breast cancer patients (p < 0.0001). After controlling for the effects of age, race, chronic kideny disease, chemotherapy, and radiation therapy autoimmune disease was still predictive of improved OS (HR: 1.45, 95% CI: 1.35-1.55, p < 0.0001) and CSM (HR: 1.40, 95% CI: 1.29-1.5, p < 0.0001). By contrast, in patients with stage I-III breast cancer, the presence of an autoimmune diagnosis was associated with a lower OS (p < 0.0001, p < 0.0001, and p = 0.026, respectively), compared to patients without autoimmune disease.

conclusionsWe found a higher prevalence of rheumatoid arthritis, Crohn's disease, ulcerative colitis, and systemic lupus erythematosus in patients with breast cancer compared to age matched cohorts in the general population. The presence of an autoimmune diagnosis was associated with a lower OS in stages I-III breast cancer and improved OS and CSM in patients with stage IV disease. These results suggest that anti-tumor immunity plays an important role in late stage breast cancer and could potentially be exploited to improve the effectiveness of immunotherapy.

Indexed as

Autoimmune DiseasesBreast NeoplasmsAgedFemaleHumansMedicareNeoplasm StagingSEER ProgramUnited Statesautoimmune diseasesbreast neoplasmsMedicare; statistics & numerical dataprevalenceSEER program; statistics & numerical datasurvival analysis

Identifiers

PMID37102221
PMCPMC10315719
OpenAlexW4367174944

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.