Herpes zoster risk among female survivors of breast cancer in Japan.
20 affiliations
- 1Department of Digital Health, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
- 2Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- 3Tsukuba Institute for Advanced Research, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- 4Department of Clinical Research and Regional Innovation, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- 5Translational Research Promotion Center, Tsukuba Clinical Research & Development Organization (T-CReDO), University of Tsukuba, Tsukuba, Ibaraki, Japan.
- 6Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- 7Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
- 8Division of Health Services Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan.
- 9Department of Breast and Endocrine Surgery, School of Public Health, The University of Tokyo, Tokyo, Japan.
- 10Department of Breast Surgical Oncology, Sagara Hospital, Social Medical Corporation Hakuaikai, Kagoshima, Japan.
- 11Department of Breast and Endocrine Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- 12Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan.
- 13Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- 14Clinical Translational Science, Juntendo University School of Medicine Graduate School of Medicine, Tokyo, Japan.
- 15Medical Technology Innovation Center, Juntendo University, Tokyo, Japan.
- 16Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- 17Department of Digital Health, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan. [email protected].
- 18Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. [email protected].
- 19Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan. [email protected].
- 20Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK. [email protected].
Abstract
Background
Survivors of breast cancer (BC) have a higher risk of developing herpes zoster (HZ), but it remains unclear how this risk is affected by time since BC diagnosis and treatment regimen.Methods
This matched cohort study used a large health-insurance claims database including Japanese employees and their families. Between January 2005 and December 2019, women aged 18-74 years with and without incident BC were matched 1:4 by age and timing of database entry, in the month of BC diagnosis. This study aimed to evaluate the risk of developing HZ in female BC survivors compared with women without BC, to examine temporal variations in risk during survivorship, and to assess the impact of different BC treatments on this risk. We compared the first HZ incidence using stratified Cox regression analyses over the study period, divided by follow-up length. We then estimated HZ risk by treatment regimen using unstratified Cox regression analysis, with follow-up beginning 1 year after matching.Results
Comparing 23,169 BC survivors vs 92,801 matched women without BC (median age: 49.4 years, interquartile range: 44.7-56.0 years), the HZ incidence rate (95% confidence interval) was higher in the survivors (16.5 [15.6-17.5] vs 10.6 [10.3-11.0]/1000 person-years), with an adjusted hazard ratio (aHR) of 1.57 (1.46-1.68) over the whole period. This aHR decreased over time but remained elevated up to 10 years (0-1 year: 1.90 [1.68-2.16]; 1-2 years: 1.64 [1.42-1.89]; 2-3 years: 1.30 [1.08-1.57]; 3-10 years: 1.37 [1.20-1.56]). The aHRs were 1.15 (0.98-1.36), 1.64 (1.16-2.30), 1.23 (0.94-1.62), and 1.60 (1.30-1.97), respectively, for survivors who received no chemotherapy, anthracycline-only, taxane-only, and anthracycline-plus-taxane, compared with women without BC.Conclusions
Female BC survivors in Japan had a higher HZ risk compared with the general age-matched female Japanese population. HZ vaccination should therefore be promoted for BC survivors.
Related
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- Herpes Zoster in an Immunocompetent Child Following an Influenza-Like Illness
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BibTeX
@article{kawamura2026herpes,
title = {{Herpes zoster risk among female survivors of breast cancer in Japan.}},
author = {Chitose Kawamura and Kensuke Shimada and Krishnan Bhaskaran and Takaaki Konishi and Yasuaki Sagara and Hiroko Bando and Tomohiro Shinozaki and Shuko Nojiri and Motohiko Adomi and Angel Y S Wong and Nanako Tamiya and Masao Iwagami},
journal = {Breast cancer research : BCR},
year = {2026},
month = jul,
doi = {10.1186/s13058-026-02345-1},
url = {https://europepmc.org/article/MED/42897568},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Herpes zoster risk among female survivors of breast cancer in Japan.
AU - Chitose Kawamura
AU - Kensuke Shimada
AU - Krishnan Bhaskaran
AU - Takaaki Konishi
AU - Yasuaki Sagara
AU - Hiroko Bando
AU - Tomohiro Shinozaki
AU - Shuko Nojiri
AU - Motohiko Adomi
AU - Angel Y S Wong
AU - Nanako Tamiya
AU - Masao Iwagami
PY - 2026
DA - 2026/07/01
JO - Breast cancer research : BCR
DO - 10.1186/s13058-026-02345-1
UR - https://europepmc.org/article/MED/42897568
AB - Background Survivors of breast cancer (BC) have a higher risk of developing herpes zoster (HZ), but it remains unclear how this risk is affected by time since BC diagnosis and treatment regimen.Methods This matched cohort study used a large health-insurance claims database including Japanese employees and their families. Between January 2005 and December 2019, women aged 18-74 years with and without incident BC were matched 1:4 by age and timing of database entry, in the month of BC diagnosis. This study aimed to evaluate the risk of developing HZ in female BC survivors compared with women without BC, to examine temporal variations in risk during survivorship, and to assess the impact of different BC treatments on this risk. We compared the first HZ incidence using stratified Cox regression analyses over the study period, divided by follow-up length. We then estimated HZ risk by treatment regimen using unstratified Cox regression analysis, with follow-up beginning 1 year after matching.Results Comparing 23,169 BC survivors vs 92,801 matched women without BC (median age: 49.4 years, interquartile range: 44.7-56.0 years), the HZ incidence rate (95% confidence interval) was higher in the survivors (16.5 [15.6-17.5] vs 10.6 [10.3-11.0]/1000 person-years), with an adjusted hazard ratio (aHR) of 1.57 (1.46-1.68) over the whole period. This aHR decreased over time but remained elevated up to 10 years (0-1 year: 1.90 [1.68-2.16]; 1-2 years: 1.64 [1.42-1.89]; 2-3 years: 1.30 [1.08-1.57]; 3-10 years: 1.37 [1.20-1.56]). The aHRs were 1.15 (0.98-1.36), 1.64 (1.16-2.30), 1.23 (0.94-1.62), and 1.60 (1.30-1.97), respectively, for survivors who received no chemotherapy, anthracycline-only, taxane-only, and anthracycline-plus-taxane, compared with women without BC.Conclusions Female BC survivors in Japan had a higher HZ risk compared with the general age-matched female Japanese population. HZ vaccination should therefore be promoted for BC survivors.
SN - 1465-5411
SN - 1465-542X
ER -