Relation of Alcohol/Tobacco use with Metastasis, Hormonal (Estrogen and Progesterone) Receptor Status and c-erbB2 Protein in Mammary Ductal Carcinoma


Background: An association between alcohol/tobacco use and risk of metastasis in breast cancer has beenclearly shown. Materials and
Methods: The present study explored, in 48 samples of tissue from mammaryductal carcinoma (taken from Mexican women with an average age of 58.2±10.9 years), the association of riskof metastasis with the status of hormonal receptors and the c-erbB2 protein (by immunohistochemistry) as wellas clinical, histopathological and sociodemographic factors.
Results: Of 48 patients, 41.6% (20/48) presentedwith metastasis, 43.8% were positive for the estrogen receptor (RE+), 31.3% for the progesterone receptor(RP+) and 47.7% for c-erbB2 (c-erbB2+). The following combinations were found: RE+/RP+/c-erbB2+ 8.3%,RE+/RP+ 22.9%, RE+/RP- 20.8%, RE-/RP+ 8.3%, RE-/RP-/c-erbB2- 22.9% and RE-/RP- 47.8%. There were12 patients who used alcohol/tobacco, of which 91.6% did not present metastasis and 81.9% were RE-/RP-.Compared to the RE-/RP-/c-erbB2+, the RE+/RP+/c-erbB2+ group had a 15-fold greater risk for metastasis(95%CI, 0.9-228.8, p=0.05). The carriers of the double negative hormonal receptors had a 4.7 fold greaterprobability of being (or having been) smokers or drinkers (95%CI, 1.0-20.4, p = 0.03).
Conclusions: There wasa clear protective effect of using alcohol and/or tobacco, in the cases included in the present study of mammaryductal carcinoma, associated with double negative hormonal receptors. However, this association could be dueto a protective factor not measured (Neyman bias) or to a bias inherent in the rate of hospitalization (Berksonfallacy). This question should be explored in a broad prospective longitudinal study.