Characteristics and prognosis of breast cancer after liver or kidney transplantation

• Published in: Breast cancer research and treatment Vol. 167; no. 1; pp. 101 - 106
• Main Authors: Jeong, I-Ji, Lee, Sung-Gyu, Kim, Young Hoon, Ko, Beom Seok, Lee, Jong Won, Son, Byung Ho, Ahn, Se-Hyun, Kim, Hee Jeong
• Format: Journal Article
• Language: English
• Published: New York Springer US 2018; Springer; Springer Nature B.V
• Subjects: Adult; Age; Aged; Breast cancer; Breast Neoplasms - epidemiology; Breast Neoplasms - etiology; Breast Neoplasms - genetics; Breast Neoplasms - pathology; Cancer metastasis; Cancer patients; Cancer research; Cancer screening; Clinical Trial; Comparative analysis; Diagnosis; ErbB-2 protein; Female; Health aspects; Humans; Immunosuppressive agents; Kidney transplantation; Kidney Transplantation - adverse effects; Kidney transplants; Liver; Liver cancer; Liver diseases; Liver transplantation; Liver Transplantation - adverse effects; Liver transplants; Lymph; Lymph nodes; Lymphatic Metastasis; Lymphatic system; Mammography; Medical centers; Medical diagnosis; Medical prognosis; Medicine; Medicine & Public Health; Metastases; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - etiology; Neoplasm Recurrence, Local - genetics; Neoplasm Recurrence, Local - pathology; Oncology; Progesterone; Prognosis; Receptor, ErbB-2 - genetics; Receptors, Estrogen - genetics; Receptors, Progesterone - genetics; Retrospective Studies; Transplants & implants; Breast cancer; Liver transplantation; Kidney transplantation; Post-transplant malignancy
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-017-4504-1

Purpose Immunoediting is crucial in cancer development and progression. This study compared the characteristics and prognosis of post-transplant breast cancer (PTBC) patients receiving immunosuppressants and general breast cancer patients. Methods Data from the Asan Medical Center Breast Cancer (AMCBC), kidney transplantation, and liver transplantation databases recorded during 1989–2013 were retrospectively analyzed. Four controls of AMCBC cohort per one case of PTBC cohort were selected based on tumor size, lymph node metastasis, and age. Results After a median of 61 and 90.8 months after liver and kidney transplantation, respectively, 8 and 16 patients were diagnosed with breast cancer, respectively ( p  = 0.178). Mean age at breast cancer diagnosis was 51.9 (±8.7) and 45.2 (±4.5) years in liver and kidney transplantation patients, respectively. Age at diagnosis was significantly younger in kidney transplantation patients than in general breast cancer patients (45.2 ± 4.5 vs. 48.5 ± 10.1 years; p  = 0.008). Cancer was detected via asymptomatic screening in 41.7% of the PTBC cohort but 30.6% of the control cohort ( p  = 0.241). In the PTBC cohort, 7 (29.2%) patients had stage 0 breast cancer compared with 1704 (9.7%) in the control cohort ( p  = 0.022); 22 (91.7%) patients had lymph node-negative cancer compared with 11,704 (66.8%) in the control cohort ( p  = 0.01). Estrogen receptor, progesterone receptor, and HER2 positivity did not differ between cohorts. Immunosuppressant use was not a poor prognostic factor for breast cancer patients. Conclusions Age at breast cancer diagnosis was younger in patients who received kidney transplants; the subtype and prognosis of breast cancer were comparable with that in the general cohort. Immunosuppressants do not adversely affect breast cancer prognosis.