Abstract | PURPOSE: EXPERIMENTAL DESIGN: A Swedish population-based study including 4,261 women diagnosed with primary invasive breast cancer between 2001 and 2008 in Stockholm, followed until 2012. Risk stratification by chemotherapy and genetic susceptibility [a polygenic risk score (PRS), including nine established VTE loci] was assessed using Kaplan-Meier and flexible parametric survival analyses, adjusting for patient, tumor, and treatment characteristics. RESULTS: In total, 276 patients experienced a VTE event during a median follow-up of 7.6 years. Patients receiving chemotherapy [HR (95% CI) = 1.98; 1.40-2.80] and patients in the highest 5% of the PRS [HR (95% CI) = 1.90; 1.24-2.91] were at increased risk of developing VTE. Chemotherapy and PRS acted independently on VTE risk and the 1-year cumulative incidence in patients carrying both risk factors was 9.5% compared with 1.3% in patients not having these risk factors (P < 0.001). Stratified analyses by age showed that the risk-increasing effect of PRS was stronger in older patients (P interaction = 0.04), resulting in an excess risk among genetically susceptible patients receiving chemotherapy aged ≥ 60 years (1-year cumulative incidence = 25.0%). CONCLUSIONS:
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Authors | Judith S Brand, Elham Hedayati, Keith Humphreys, Jonas F Ludvigsson, Anna L V Johansson, Jonas Bergh, Per Hall, Kamila Czene |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 22
Issue 21
Pg. 5249-5255
(Nov 01 2016)
ISSN: 1557-3265 [Electronic] United States |
PMID | 27803117
(Publication Type: Journal Article)
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Copyright | ©2016 American Association for Cancer Research. |
Topics |
- Breast Neoplasms
(complications, genetics)
- Female
- Follow-Up Studies
- Genetic Predisposition to Disease
(genetics)
- Humans
- Middle Aged
- Risk Factors
- Survival Analysis
- Sweden
- Venous Thromboembolism
(etiology, genetics)
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