Association between Oestrogens Receptor Expressions in Breast Cancer and Comorbidities: A Cross-Sectional, Population-Based Study

BACKGROUND Breast cancer with oestrogen receptor expression is common in older women. Several factors, such as age and reproductive hormone exposure, have been associated with oestrogen receptor expression in breast cancer. However, the association between comorbidities and the oestrogen receptor expression has been poorly studied. We hypothesized that there was an association between burden comorbidity and breast cancer with oestrogen receptor expression in older women. OBJECTIVE To determine whether oestrogen receptor expression in breast cancer was associated with burden comorbidity in community-dwelling women. METHODS A total of 1,707 women with breast cancer registered on the list of a breast cancer registry were included. The recorded data included: age, Charlson Comorbidity Index score≥1, breast cancer characteristics (coded according to the International Classification of Diseases for Oncology), and breast cancer pathological stage (the pathological-tumour-node-metastasis, Scarff Bloom Richardson, and hormonal status of oestrogen receptor, progesterone receptor, and human epidermal growth factor receptor). RESULTS Breast cancer with oestrogen receptor expression was identified in 1,378 patients (80·7%). The fully-adjusted logistic regression showed that oestrogen receptor expression was associated with Charlson Comorbidity Index score≥1 (odds ratio [OR] = 1·91,95%confidence interval [CI] = [1.01-3.61], P = 0·048), progesterone receptor expression (OR = 16·64, 95%CI = [11.62-23.81], P<0·001), human epidermal growth factor receptor (OR = 0·54, 95%CI = [0.34-0.84], P = 0·007), age (OR = 1.02, 95%CI = [1.00-1.03], P = 0.008), Scarff Bloom Richardson grade II and grade III (OR = 0·21with 95%CI = [0.10-0.44] and OR = 0·06 with 95%CI = [0.03-0.12], P<0·001). CONCLUSION Our findings provide new data showing an independent positive association between burden comorbidity and breast cancer with oestrogen receptor expression. This result confirms that evaluation of oestrogen receptor expression in breast cancer should not be limited to hormonal factors stratified by age.