Systemic glucocorticoids and the risk of breast cancer in a large nationwide case-control study.

IF 5.6 1区医学 Q1 Medicine

Breast Cancer Research Pub Date : 2025-06-23 DOI:10.1186/s13058-025-02071-0

Manon Cairat, Morten Olesen, Elea Olivier, Anton Pottegård, Blánaid Hicks

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Abstract

Background: Concerns have been raised that long-term use of glucocorticoids may increase the risk of breast cancer, yet evidence is limited. Thus, this study investigated the association between systemic glucocorticoid use and breast cancer risk, overall and by breast cancer subtype and stage.

Methods: A nationwide case-control study was conducted using the Danish healthcare registries. Women with invasive breast cancer between 2001 and 2018 (n = 67,829) were identified as cases. Each case was matched to 10 population controls on age and calendar time. Ever users of glucocorticoids were defined as women who filled at least 2 prescriptions and long-term users those who filled prescriptions equivalent to ≥ 1000 defined daily doses (DDDs). Conditional logistic regressions were performed to calculate odds ratios (ORs) and 95% confidence intervals for the associations between glucocorticoid use and breast cancer risk.

Results: Twelve percent of women (n = 87,277) had ever been exposed to glucocorticoids and fewer than 1% were long-term users (n = 5,574). No association was found between ever use of glucocorticoids and breast cancer risk [OR = 1.00 (0.98-1.03)], compared with never use. However, an inverse association was observed between long-term glucocorticoid use and breast cancer risk [OR = 0.87 (0.77-0.97)], with suggestion of a slight dose-response relationship [OR per 500 DDDs = 0.96 (0.94-0.99)]. The associations were consistent across different tumour subtypes, estrogen receptor status, or clinical stage at diagnosis.

Conclusion: The findings from this large nationwide study did not suggest a positive association between glucocorticoids and breast cancer risk.

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系统性糖皮质激素与乳腺癌风险的关系：一项全国性的病例对照研究。

背景：长期使用糖皮质激素可能会增加乳腺癌的风险，但证据有限。因此，本研究调查了全身糖皮质激素使用与乳腺癌风险之间的关系，总体上以及乳腺癌亚型和分期。方法：使用丹麦卫生保健登记处进行了一项全国性的病例对照研究。2001年至2018年期间患有浸润性乳腺癌的女性（n = 67,829）被确定为病例。每个病例在年龄和日历时间上与10个人口控制相匹配。曾经使用糖皮质激素的女性定义为至少使用2种处方，长期使用糖皮质激素的女性定义为使用相当于≥1000定义日剂量（DDDs）的处方的女性。使用条件logistic回归来计算糖皮质激素使用与乳腺癌风险之间的比值比（ORs）和95%可信区间。结果：12%的女性（n = 87,277）曾经接触过糖皮质激素，不到1%的女性是长期使用者（n = 5,574）。与从未使用糖皮质激素相比，从未使用糖皮质激素与乳腺癌风险无关联[OR = 1.00(0.98-1.03)]。然而，长期使用糖皮质激素与乳腺癌风险呈负相关[OR = 0.87(0.77-0.97)]，提示存在轻微的剂量-反应关系[OR / 500 DDDs = 0.96(0.94-0.99)]。这种关联在不同的肿瘤亚型、雌激素受体状态或诊断时的临床阶段是一致的。结论：这项大型全国性研究的结果并未表明糖皮质激素与乳腺癌风险之间存在正相关关系。

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来源期刊

Breast Cancer Research ONCOLOGY-

CiteScore

12.00

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： Breast Cancer Research, an international, peer-reviewed online journal, publishes original research, reviews, editorials, and reports. It features open-access research articles of exceptional interest across all areas of biology and medicine relevant to breast cancer. This includes normal mammary gland biology, with a special emphasis on the genetic, biochemical, and cellular basis of breast cancer. In addition to basic research, the journal covers preclinical, translational, and clinical studies with a biological basis, including Phase I and Phase II trials.