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Luo S, Zhang X, Wang Z. Breast mucosa-associated lymphoid tissue lymphoma: A case report and literature review. Medicine (Baltimore) 2024; 103:e37895. [PMID: 38640287 PMCID: PMC11029987 DOI: 10.1097/md.0000000000037895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Mucosa-associated lymphoid tissue (MALT) lymphoma, also known as extranodal marginal zone lymphoma, is more commonly detected in the stomach and rarely in the breast. Our study presented a clinical and pathological examination of a patient diagnosed with breast MALT lymphoma, supplemented with pertinent research, to offer guidance for the diagnosis and treatment of this condition. PEOPLE CONCERNS The occurrence of breast MALT lymphoma has risen in the past decade, but its etiology, progression and treatment response are less well-studied. DIAGNOSIS Breast MALT lymphoma was diagnosed by excisional biopsy and histopathology. INTERVENTIONS Following breast MALT lymphoma diagnosis, the patient was transferred to the hematology department for further treatment, and she made the decision to continue observing. OUTCOMES After 3 months of observation, the patient remained asymptomatic. CONCLUSION Breast MALT lymphoma is an indolent disease with an asymptomatic presentation, There are no standardized treatment guidelines for breast MALT lymphoma, treatment must be tailored to the patient willingness to treat and the severity of the disease. Hence, in order to give patients a better chance of cure, more research is needed to explore its pathogenesis and more clinical trials are needed investigate the treatment of this disease.
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Affiliation(s)
- Siyi Luo
- Department of Breast, Jiujiang NO.1 People’s Hospital, Jiujiang, People’s Republic of China
| | - Xinyue Zhang
- Department of Pathology, Jiujiang NO.1 People’s Hospital, Jiujiang, People’s Republic of China
| | - Zhichun Wang
- Department of Breast, Jiujiang NO.1 People’s Hospital, Jiujiang, People’s Republic of China
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2
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Luo J, Hendryx M, Rohan TE, Saquib N, Shadyab AH, Su L, Hosgood D, Schnatz PF, Qi L, Anderson GL. Hysterectomy, oophorectomy and risk of non-Hodgkin's lymphoma. Int J Cancer 2024; 154:1433-1442. [PMID: 38112671 PMCID: PMC10922604 DOI: 10.1002/ijc.34820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023]
Abstract
Hysterectomy is associated with an increased risk for adverse health outcomes. However, its connection to the risk of non-Hodgkin's lymphoma (NHL) remains unclear. The aims of our study were to investigate the associations between hysterectomy, oophorectomy and risk of NHL and its major subtypes (eg, diffuse large B-cell lymphoma [DLBCL]), and whether these associations were modified by exogenous hormone use. Postmenopausal women (n = 141,621) aged 50-79 years at enrollment (1993-1998) from the Women's Health Initiative were followed for an average of 17.2 years. Hysterectomy and oophorectomy were self-reported at baseline. Incident NHL cases were confirmed by central review of medical records and pathology reports. During the follow-up period, a total of 1719 women were diagnosed with NHL. Hysterectomy, regardless of oophorectomy status, was associated with an increased risk of NHL (hazard ratio [HR] = 1.23, 95% confidence interval [CI]: 1.05-1.44). Oophorectomy was not independently associated with NHL risk after adjusting for hysterectomy. When stratified by hormone use, the association between hysterectomy and NHL risk was confined to women who had never used hormone therapy (HR = 1.35, 95% CI: 1.06-1.71), especially for DLBCL subtype (P for interaction = .01), and to those who had undergone hysterectomy before the age of 55. Our large prospective study showed that hysterectomy was a risk factor of NHL. Findings varied by hormone use. Future studies incorporating detailed information on the types and indications of hysterectomy may deepen our understanding of the mechanisms underlying DLBCL development and its potential interactions with hormone use.
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Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN
| | - Thomas E Rohan
- Epidemiology & Population Health, Albert Einstein College of Medicine. Bronx, NY
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukairiyah, Kingdom of Saudi Arabia
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA
| | - Le Su
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Dean Hosgood
- Epidemiology & Population Health, Albert Einstein College of Medicine. Bronx, NY
| | - Peter F. Schnatz
- Department of Obstetrics & Gynecology and Internal Medicine, Drexel University, West Reading, PA
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA
| | - Garnet L Anderson
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., PO Box 19024, Seattle, WA
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3
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Costas L, Lujan-Barroso L, Benavente Y, Allen NE, Amiano P, Ardanaz E, Besson C, Boeing H, Bueno-de-Mesquita B, Cervenka I, Fortner RT, Fournier A, Gunter M, Harlid S, Huerta JM, Jerkeman M, Jirström K, Kaaks R, Karakatsani A, Khaw KT, Kotanidou A, Lund E, Masala G, Mattiello A, Melin B, Menéndez V, Murphy N, Nieters A, Overvad K, Riboli E, Sacerdote C, Sánchez MJ, Schmidt JA, Sieri S, Tjønneland A, Trichopoulou A, Tumino R, Vermeulen R, Weiderpass E, de Sanjosé S, Agudo A, Casabonne D. Reproductive Factors, Exogenous Hormone Use, and Risk of B-Cell Non-Hodgkin Lymphoma in a Cohort of Women From the European Prospective Investigation Into Cancer and Nutrition. Am J Epidemiol 2019; 188:274-281. [PMID: 30481275 PMCID: PMC6357796 DOI: 10.1093/aje/kwy259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 12/24/2022] Open
Abstract
The role of hormonal factors in the etiology of lymphoid neoplasms remains unclear. Previous studies have yielded conflicting results, have lacked sufficient statistical power to assess many lymphoma subtypes, or have lacked detailed information on relevant exposures. Within the European Prospective Investigation Into Cancer and Nutrition cohort, we analyzed comprehensive data on reproductive factors and exogenous hormone use collected at baseline (1992-2000) among 343,458 women, including data on 1,427 incident cases of B-cell non-Hodgkin lymphoma (NHL) and its major subtypes identified after a mean follow-up period of 14 years (through 2015). We estimated hazard ratios and 95% confidence intervals using multivariable proportional hazards modeling. Overall, we observed no statistically significant associations between parity, age at first birth, breastfeeding, oral contraceptive use, or ever use of postmenopausal hormone therapy and risk of B-cell NHL or its subtypes. Women who had undergone surgical menopause had a 51% higher risk of B-cell NHL (based on 67 cases) than women with natural menopause (hazard ratio = 1.51, 95% confidence interval: 1.17, 1.94). Given that this result may have been due to chance, our results provide little support for the hypothesis that sex hormones play a role in lymphomagenesis.
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Affiliation(s)
- Laura Costas
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
| | - Leila Lujan-Barroso
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
- Department of Nursing of Public Health, Mental Health and Maternity and Child Health, School of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Benavente
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Health Research Institute, San Sebastian, Spain
| | - Eva Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
| | - Caroline Besson
- Unit of Hematology-Oncology, Centre Hospitalier de Versailles, Le Chesnay, France
- Centre de Recherche en Epidémiologie et Santé des Populations, Faculté de Médecine–Université Paris-Sud and Faculté de Médecine–Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Bas Bueno-de-Mesquita
- Department of Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary’s Campus, London, United Kingdom
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Iris Cervenka
- Centre de Recherche en Epidémiologie et Santé des Populations, Faculté de Médecine–Université Paris-Sud and Faculté de Médecine–Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Agnès Fournier
- Centre de Recherche en Epidémiologie et Santé des Populations, Faculté de Médecine–Université Paris-Sud and Faculté de Médecine–Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Marc Gunter
- International Agency for Research on Cancer, Lyon, France
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - José María Huerta
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Murcia, Spain
| | - Mats Jerkeman
- Division of Oncology and Pathology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Karin Jirström
- Division of Oncology and Pathology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- Department of Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, Attikon University General Hospital, Haidari, Greece
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Anastasia Kotanidou
- Hellenic Health Foundation, Athens, Greece
- Department of Critical Care Medicine and Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, Athens, Greece
| | - Eiliv Lund
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirugia, Federico II University, Naples, Italy
| | - Beatrice Melin
- Department of Radiation Sciences, Oncology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | | | - Neil Murphy
- International Agency for Research on Cancer, Lyon, France
| | - Alexandra Nieters
- Center for Chronic Immunodeficiency at the Center for Translational Cell Research, University of Freiburg Medical Center, Freiburg, Germany
| | - Kim Overvad
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention, Turin, Italy
| | - Maria-Jose Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS-Istituto Nazionale dei Tumori, Milano, Italy
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Rosario Tumino
- Cancer Registry and Histopathology Department, Maria Paternò Arezzo Hospital, Ragusa, Italy
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Elisabete Weiderpass
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
| | - Delphine Casabonne
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
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4
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Jia Y, Sun C, Liu Z, Wang W, Zhou X. Primary breast diffuse large B-cell lymphoma: a population-based study from 1975 to 2014. Oncotarget 2018; 9:3956-3967. [PMID: 29423097 PMCID: PMC5790514 DOI: 10.18632/oncotarget.23285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022] Open
Abstract
Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare non-Hodgkin's lymphoma with limited data. In this study, a population-based study of primary breast DLBCL in the United States was performed to determine its incidence trends, prognostic factors, survival, the role of surgery as well as the comparison with nodal DLBCL. 1021 patients diagnosed with breast DLBCL were identified in the Surveillance, Epidemiology, and End Results (SEER) cancer registries from 1973-2014. The incidence of both breast and nodal DLBCL increased over time. Patients with breast DLBCL were older, mainly women, diagnosed at earlier stages and had lower prevalence in white and black races compared with nodal DLBCL. Multivariate analysis revealed older age (≥ 70 years old) and advanced stage as independent predictors of worse OS. Independent predictor of better DSS were younger age (< 70 years old), early stage and diagnosis after 2000. When analyzed according to age, stage, race, tumor laterality and year of diagnosis, the overall survival did not benefit from surgery except in patients diagnosed between 2001-2010 and the surgery rate decreased overtime. Compared with nodal DLBCL, breast DLBCL patients exhibited a better outcome. In conclusion, breast DLBCL is a rare tumor with increasing incidence and improved survival over the last four decades. The introduction of rituximab seems to improve the outcome of breast DLBCL. Further studies are needed to advance our understanding of breast DLBCL and optimize the treatment strategy.
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Affiliation(s)
- Yijun Jia
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China
| | - Chenbo Sun
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China
| | - Zebing Liu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China.,Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Weige Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China
| | - Xiaoyan Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Institute of Pathology, Fudan University, Shanghai 200032, China
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5
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Primary MALT Lymphoma of the Breast Treated with Definitive Radiation. Case Rep Hematol 2016; 2016:1831792. [PMID: 27247809 PMCID: PMC4877461 DOI: 10.1155/2016/1831792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/14/2016] [Accepted: 04/17/2016] [Indexed: 01/22/2023] Open
Abstract
We are reporting a case of a 59-year-old woman, with a family history of breast cancer, who presented with extranodal marginal zone lymphoma (MALT) of the left breast. She received definitive radiation therapy and remains without evidence of disease. Here, we present a case and review the current literature to determine the optimal treatment of this rare presentation of MALT.
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Kato I, Chlebowski RT, Hou L, Wactawski-Wende J, Ray RM, Abrams J, Bock C, Desai P, Simon MS. Menopausal estrogen therapy and non-Hodgkin's lymphoma: A post-hocanalysis of women's health initiative randomized clinical trial. Int J Cancer 2016; 138:604-11. [DOI: 10.1002/ijc.29819] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/14/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Ikuko Kato
- Department of Oncology; Wayne State University School of Medicine; Detroit MI
- Department of Pathology; Wayne State University School of Medicine; Detroit MI
| | - Rowan T. Chlebowski
- Division of Medical Oncology and Hematology, Department of Medicine; Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angels Medical Center; Torrance CA
| | - Lifang Hou
- Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine; Northwestern University; Evanston IL
| | - Jean Wactawski-Wende
- Departments of Epidemiology and Environmental Health; University of Buffalo; Buffalo NY
| | - Roberta M. Ray
- Division of Public Health Sciences; Fred Hutchinson Cancer Research Center; Seattle WA
| | - Judith Abrams
- Department of Oncology; Wayne State University School of Medicine; Detroit MI
| | - Cathryn Bock
- Department of Oncology; Wayne State University School of Medicine; Detroit MI
| | - Pinkal Desai
- Division of Hematology and Oncology, Department of Medicine; Weill Cornell Medical College; New York NY
| | - Michael S Simon
- Department of Oncology; Wayne State University School of Medicine; Detroit MI
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7
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Leal AD, Thompson CA, Wang AH, Vierkant RA, Habermann TM, Ross JA, Mesa RA, Virnig BA, Cerhan JR. Hormonal and Reproductive Factors and Risk of Myeloproliferative Neoplasms in Postmenopausal Women. Cancer Epidemiol Biomarkers Prev 2015; 25:151-7. [PMID: 26564251 DOI: 10.1158/1055-9965.epi-15-0613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 11/04/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hormonal and reproductive history has been associated with risk of some hematologic malignancies, but their role in myeloproliferative neoplasms (MPN) is largely unknown. METHODS Using a population-based cohort study, we evaluated the association of these factors with risk of MPN overall, and for essential thrombocythemia (ET) and polycythemia vera (PV) specifically. Incident MPN cases from 1993 to 2004 were identified via linkage to Medicare. RR and 95% confidence intervals (CI) were estimated utilizing Cox proportional hazard regression. RESULTS After >250,000 person-years of follow-up, 257 cases of MPN were identified (172 ET, 64 PV). Ever use of hormone therapy (HT) was associated with an increased risk of ET (RR = 1.63; 95% CI, 1.19-2.23) but a decreased risk of PV (RR = 0.58; 95% CI, 0.34-0.98). There were no statistically significant associations of oral contraceptives or reproductive factors with MPN risk overall, or by MPN subtype. Bilateral oophorectomy was associated with increased risk of ET (RR = 1.58; 95% CI, 1.11-2.25) and decreased risk of PV (RR = 0.32; 95% CI, 0.12-0.88). There was no association of ovulatory years with ET risk; however, there was increased risk of PV (RR = 1.68 for >36.8 compared with ≤27.6 years; P trend = 0.045). Adjustment for potential confounding factors did not alter these associations. CONCLUSIONS HT use and bilateral oophorectomy had opposite associations for ET and PV. Except for ovulatory years and PV risk, reproductive history did not appear to play a role in the etiology of MPN. IMPACT This study suggests different mechanistic impacts of estrogen, and perhaps distinct etiologies, for the two major MPN subtypes.
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Affiliation(s)
- Alexis D Leal
- Division of Hematology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Carrie A Thompson
- Division of Hematology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Alice H Wang
- Divison of Biomedical Statistics and Informatics, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Robert A Vierkant
- Divison of Biomedical Statistics and Informatics, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Thomas M Habermann
- Division of Hematology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Julie A Ross
- Division of Epidemiology and Clinical Research, Department of Pediatrics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Ruben A Mesa
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, Arizona
| | - Beth A Virnig
- Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota.
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8
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Costas L, de Sanjosé S, Infante-Rivard C. Reproductive factors and non-Hodgkin lymphoma: a systematic review. Crit Rev Oncol Hematol 2014; 92:181-93. [PMID: 25132165 DOI: 10.1016/j.critrevonc.2014.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 05/08/2014] [Accepted: 07/23/2014] [Indexed: 02/07/2023] Open
Abstract
Considerable efforts have been made to elucidate non-Hodgkin lymphoma's (NHL) etiology during the last decades. Some evidence points to an association with reproductive factors, as incidence rates for most NHL subtypes are usually higher in men than in women, and several subtypes express hormonal receptors. Although the evidence is not compelling, some studies show an inverse association with gravidity. Associations with postmenopausal hormone therapy are usually derived from unopposed estrogen use, rather than for the combination of estrogen with progestin, but these findings vary by study design. Inconsistencies in the results are likely due to the complex relationship between reproductive, biological, and sociodemographic factors, as well as to study limitations. Elucidating the role of hormonal factors should provide clues for therapeutic options and public health decisions. We provide an overview of the available evidence on reproductive factors in NHL etiology, underscoring potential sources of discrepancies and bias.
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Affiliation(s)
- Laura Costas
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain; Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada.
| | - Silvia de Sanjosé
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
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9
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Primary breast lymphoma. Cancer Treat Rev 2014; 40:900-8. [PMID: 24953564 DOI: 10.1016/j.ctrv.2014.05.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/22/2014] [Accepted: 05/26/2014] [Indexed: 01/01/2023]
Abstract
Primary breast lymphoma is a rare form of extranodal lymphoma, defined by the presence of a primary lesion within the breast with or without regional nodal involvement but no other extra-mammary sites of involvement. It comprises diverse histologic subtypes, but diffuse large B-cell lymphoma is the most common. In this review, we describe in detail the clinical features, diagnosis and staging, pathogenesis, risk factors and therapy of primary breast diffuse large B-cell lymphoma. We consider choice and number of cycles of chemotherapy, the indications for radiotherapy and discuss the need for central nervous system prophylaxis. We also provide a brief overview of the less commonly encountered histologic subtypes including marginal zone, follicular, Burkitt and breast implant associated anaplastic large cell lymphoma. We conclude with a suggested treatment approach and potential areas of future research.
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10
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Bretherick KL, Schuetz JM, Morton LM, Purdue MP, Conde L, Gallagher RP, Connors JM, Gascoyne RD, Berry BR, Armstrong B, Kricker A, Vajdic CM, Grulich A, Hjalgrim H, Smedby KE, Skibola CF, Rothman N, Spinelli JJ, Brooks-Wilson AR. Sex- and subtype-specific analysis of H2AFX polymorphisms in non-Hodgkin lymphoma. PLoS One 2013; 8:e74619. [PMID: 24069324 PMCID: PMC3775730 DOI: 10.1371/journal.pone.0074619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 08/03/2013] [Indexed: 11/21/2022] Open
Abstract
H2AFX encodes a histone variant involved in signaling sites of DNA damage and recruiting repair factors. Genetic variants in H2AFX may influence risk of non-Hodgkin lymphoma (NHL), a heterogeneous group of lymphoid tumors that are characterized by chromosomal translocations. We previously reported that rs2509049, a common variant in the promoter of H2AFX, was associated with risk for NHL in the British Columbia population. Here we report results for 13 single nucleotide polymorphisms (SNPs) in 100 Kb surrounding H2AFX in an expanded collection of 568 NHL cases and 547 controls. After correction for multiple testing, significant associations were present for mantle cell lymphoma (p=0.007 for rs604714) and all B-cell lymphomas (p=0.046 for rs2509049). Strong linkage disequilibrium in the 5 Kb upstream of H2AFX limited the ability to determine which specific SNP (rs2509049, rs7759, rs8551, rs643788, rs604714, or rs603826), if any, was responsible. There was a significant interaction between sex and rs2509049 in the all B-cell lymphomas group (p=0.002); a sex-stratified analysis revealed that the association was confined to females (p=0.001). Neither the overall nor the female-specific association with rs2509049 was replicated in any of four independent NHL sample sets. Meta-analysis of all five study populations (3,882 B-cell NHL cases and 3,718 controls) supported a weak association with B-cell lymphoma (OR=0.92, 95% CI=0.86-0.99, p=0.034), although this association was not significant after exclusion of the British Columbia data. Further research into the potential sex-specificity of the H2AFX-NHL association may identify a subset of NHL cases that are influenced by genotype at this locus.
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Affiliation(s)
- Karla L. Bretherick
- Canada’s Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, British Columbia, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Johanna M. Schuetz
- Canada’s Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Lindsay M. Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Mark P. Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Lucia Conde
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California, United States of America
| | | | - Joseph M. Connors
- Division of Medical Oncology and Centre for Lymphoid Cancer, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Randy D. Gascoyne
- Department of Pathology and Centre for Lymphoid Cancer, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Brian R. Berry
- Department of Pathology, Royal Jubilee Hospital, Victoria, British Columbia, Canada
| | - Bruce Armstrong
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anne Kricker
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Claire M. Vajdic
- Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, Faculty of Medicine at the University of New South Wales, Sydney, Australia
| | - Andrew Grulich
- The Kirby Institute for infection and immunity in society, University of New South Wales, New South Wales, Australia
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Karin E. Smedby
- Unit of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Christine F. Skibola
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California, United States of America
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - John J. Spinelli
- Cancer Control Research, BC Cancer Agency, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Angela R. Brooks-Wilson
- Canada’s Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, British Columbia, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
- * E-mail:
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Teras LR, Patel AV, Hildebrand JS, Gapstur SM. Postmenopausal unopposed estrogen and estrogen plus progestin use and risk of non-Hodgkin lymphoma in the American Cancer Society Cancer Prevention Study-II Cohort. Leuk Lymphoma 2013; 54:720-5. [DOI: 10.3109/10428194.2012.722216] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Kane EV, Bernstein L, Bracci PM, Cerhan JR, Costas L, Dal Maso L, Holly EA, La Vecchia C, Matsuo K, Sanjose S, Spinelli JJ, Wang SS, Zhang Y, Zheng T, Roman E, Kricker A. Postmenopausal hormone therapy and non-Hodgkin lymphoma: a pooled analysis of InterLymph case-control studies. Ann Oncol 2013; 24:433-441. [PMID: 22967995 PMCID: PMC3551484 DOI: 10.1093/annonc/mds340] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 07/04/2012] [Accepted: 07/12/2012] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Non-Hodgkin lymphoma (NHL) subtypes, diffuse large B-cell (DLBCL) and follicular lymphoma (FL) have different sex ratios and are diagnosed at ages over 60 years; DLBCL is more common in men and diagnosed at older ages than FL, which occurs more among women. This analysis of postmenopausal women examines the relationship between postmenopausal hormone therapy and NHL. DESIGN Self-reported use of postmenopausal hormone therapy from 2094 postmenopausal women with NHL and 2731 without were pooled across nine case-control studies (1983-2005) from North America, Europe and Japan. Study-specific odds ratios (OR) and 95% confidence intervals (CI) estimated using logistic regression were pooled using random-effects meta-analyses. RESULTS Postmenopausal women who used hormone therapy were at decreased risk of NHL (pooled OR = 0.79, 95% CI 0.69-0.90). Risks were reduced when the age of starting was 50 years or older. There was no clear trend with number of years of use. Current users were at decreased risk while those stopping over 2 years before diagnosis were not. Having a hysterectomy or not did not affect the risk. Favourable effects were present for DLBCL (pooled OR = 0.66, 95% CI 0.54-0.80) and FL (pooled OR = 0.82, 95% CI 0.66-1.01). CONCLUSION Postmenopausal hormone therapy, particularly used close to menopause, is associated with a decreased risk of NHL.
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Affiliation(s)
- E V Kane
- Epidemiology and Genetics Unit, Department of Health Sciences, University of York, York, UK.
| | - L Bernstein
- Department of Population Sciences, Division of Cancer Etiology, City of Hope National Medical Center, Duarte
| | - P M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco
| | - J R Cerhan
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, USA
| | - L Costas
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, CIBERESP, Catalan Institute of Oncology, Barcelona, Spain
| | - L Dal Maso
- Epidemiology and Biostatistics Unit, Aviano Cancer Centre, Aviano
| | - E A Holly
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco
| | - C La Vecchia
- Department of Occupational Medicine, Istituto di Ricerche Farmacologiche 'Mario Negri', Universitá degli Studi di Milano, Milan, Italy
| | - K Matsuo
- Division of Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan
| | - S Sanjose
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, CIBERESP, Catalan Institute of Oncology, Barcelona, Spain
| | - J J Spinelli
- Cancer Control Research, BC Cancer Agency Research Center, Vancouver, British Columbia, Canada
| | - S S Wang
- Department of Population Sciences, Division of Cancer Etiology, City of Hope National Medical Center, Duarte
| | - Y Zhang
- School of Public Health, Yale University, New Haven, USA
| | - T Zheng
- School of Public Health, Yale University, New Haven, USA
| | - E Roman
- Epidemiology and Genetics Unit, Department of Health Sciences, University of York, York, UK
| | - A Kricker
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
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13
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Lu Y, Wang SS, Sullivan-Halley J, Chang ET, Clarke CA, Henderson KD, Ma H, Duan L, Lacey JV, Deapen D, Bernstein L. Oral contraceptives, menopausal hormone therapy use and risk of B-cell non-Hodgkin lymphoma in the California Teachers Study. Int J Cancer 2010; 129:974-82. [PMID: 20957632 DOI: 10.1002/ijc.25730] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 09/30/2010] [Indexed: 12/19/2022]
Abstract
We examined oral contraceptive (OC) and menopausal hormonal therapy (MHT) use in relation to risk of B-cell non-Hodgkin lymphoma (NHL). Women under age 85 years participating in the California Teachers Study with no history of hematopoietic cancer were followed from 1995 through 2007. A total of 516 of 114,131 women eligible for OC use analysis and 402 of 54,758 postmenopausal women eligible for MHT use analysis developed B-cell NHL. Multivariable adjusted and age stratified Cox proportional hazards models were fit to estimate relative risks (RRs) and 95% confidence intervals (95% CI). Ever versus never OC use was marginally associated with lower B-cell NHL risk, particularly among women first using OCs before age 25 years (RR=0.72, 95% CI=0.51-0.99); yet, no duration-response effect was observed. No association was observed for ever versus never MHT use among postmenopausal women (RR=1.05, 95% CI=0.83-1.33) overall or by formulation (estrogen alone, ET, or estrogen plus progestin, EPT). Among women with no MHT use, having bilateral oophorectomy plus hysterectomy was associated with greater B-cell NHL risk than having natural menopause (RR=3.15, 95% CI=1.62-6.13). Bilateral oophorectomy plus hysterectomy was not associated with risk among women who used ET or EPT. These results indicate that exogenous hormone use does not strongly influence B-cell NHL risk.
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Affiliation(s)
- Yani Lu
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA.
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14
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Mildon KH, Ansell P, Roman E, Kane EV. Reproductive factors, menopausal hormone therapy, and risk of non-Hodgkin, diffuse large B-cell and follicular lymphomas: a UK case–control study. Cancer Causes Control 2010; 21:2079-83. [DOI: 10.1007/s10552-010-9626-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 07/26/2010] [Indexed: 12/19/2022]
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15
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Morton LM, Wang SS, Richesson DA, Schatzkin A, Hollenbeck AR, Lacey JV. Reproductive factors, exogenous hormone use and risk of lymphoid neoplasms among women in the National Institutes of Health-AARP Diet and Health Study Cohort. Int J Cancer 2009; 124:2737-43. [PMID: 19253366 DOI: 10.1002/ijc.24248] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Reasons for higher incidence of lymphoid neoplasms among men than women are unknown. Because female sex hormones have immunomodulatory effects, reproductive factors and exogenous hormone use may affect risk for lymphoid malignancies. Previous epidemiologic studies on this topic have yielded conflicting results. Within the National Institutes of Health-AARP Diet and Health Study cohort, we prospectively analyzed detailed, questionnaire-derived information on menstrual and reproductive factors and use of oral contraceptives and menopausal hormone therapy among 134,074 US women. Using multivariable proportional hazards regression models, we estimated relative risks (RRs) for 85 plasma cell neoplasms and 417 non-Hodgkin lymphomas (NHLs) identified during follow-up from 1996 to 2002. We observed no statistically significant associations between plasma cell neoplasms, NHL, or the 3 most common NHL subtypes and age at menarche, parity, age at first birth, oral contraceptive use or menopausal status at baseline. For menopausal hormone therapy use, overall associations between NHL and unopposed estrogen and estrogen plus progestin were null, with the potential exception of an inverse association (RR = 0.49, 95% CI, 0.25-0.96) between use of unopposed estrogen and diffuse large B-cell lymphoma (DLBCL), the most common NHL subtype, among women with a hysterectomy. These data do not support an important role for reproductive factors or exogenous hormones in modulating lymphomagenesis.
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Affiliation(s)
- Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD 20852, USA.
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Calderon-Margalit R, Friedlander Y, Yanetz R, Kleinhaus K, Perrin MC, Manor O, Harlap S, Paltiel O. Cancer risk after exposure to treatments for ovulation induction. Am J Epidemiol 2009; 169:365-75. [PMID: 19037008 DOI: 10.1093/aje/kwn318] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Uncertainty continues as to whether treatments for ovulation induction are associated with increased risk of cancer. The authors conducted a long-term population-based historical cohort study of parous women. A total of 15,030 women in the Jerusalem Perinatal Study who gave birth in 1974-1976 participated in a postpartum survey. Cancer incidence through 2004 was analyzed using Cox's proportional hazards models, controlling for age and other covariates. Women who used drugs to induce ovulation (n = 567) had increased risks of cancer at any site (multivariate hazard ratio (HR) = 1.36, 95% confidence interval (CI): 1.06, 1.74). An increased risk of uterine cancer was found among women treated with ovulation-inducing agents (HR = 3.39, 95% CI: 1.28, 8.97), specifically clomiphene (HR = 4.56, 95% CI: 1.56, 13.34). No association was noted between use of ovulation-inducing agents and ovarian cancer (age-adjusted HR = 0.61, 95% CI: 0.08, 4.42). Ovulation induction was associated with a borderline-significant increased risk of breast cancer (multivariate HR = 1.42, 95% CI: 0.99, 2.05). Increased risks were also observed for malignant melanoma and non-Hodgkin lymphoma. These associations appeared stronger among women who waited more than 1 year to conceive. Additional follow-up studies assessing these associations by drug type, dosage, and duration are needed.
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Affiliation(s)
- R Calderon-Margalit
- Braun School of Public Health and Community Medicine, Hadassah-Hebrew University, Jerusalem, Israel.
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