Clinical course of multiple sclerosis and patient experiences during breast cancer treatment - Original Research Paper

Sep 28, 2026

Background describes that more than one-third of multiple sclerosis (MS) patients are post-menopausal women, overlapping with the primary demographic affected by breast cancer, yet little is known about combined disease clinical experiences. This case series uses a single-center retrospective review and qualitative thematic analysis to characterize oncologic and MS trajectories. Among 43 patients, relapse frequency was low, disability scores stayed stable, and outcomes were comparable to non-MS patients with similarly staged cancer.

LanguageEnglish

CategoryHealthcare

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Pages12

Reading Time30 min

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Abstract

Background and Objective

Methods and Results

Conclusions

MULTIPLE SCLEROSIS JOURNAL MSJ Original Research Paper Clinical course of multiple sclerosis and patient experiences during breast cancer treatment Alyssa N Nylander, Jessica Singh, Shane Poole, Annika Anderson, Ruth Ann Marrie, Hope Rugo and Riley Bove Abstract Background: Over one-third of multiple sclerosis (MS) patients are post-menopausal women, the primary demographic affected by breast cancer. After breast cancer diagnosis, there is little information about patients’ clinical experiences with both diseases. Objective: Utilize a case series of MS patients diagnosed with breast cancer to characterize oncologic and MS trajectories, and generate novel insights about clinical considerations using qualitative analysis. Methods: A single-center retrospective review was performed on medical record data of patients with MSand breast cancer. Thematic analysis was used to characterize experiences with the concurrent diagnoses. Results: For the 43 patients identified, mean age was 56.7years at cancer diagnosis and MS duration was 16.5 years. Approximately half were treated with MS disease modifying therapy at cancer diagnosis, and half of these subsequently discontinued or changed therapy. Altogether 14% experienced MS relapse(s) during follow-up (with 2 relapses in the first 2 years), with mean annualized relapse rate of 0.03. Cohort Expanded Disability Status Scale (EDSS) scores remained stable during follow-up. Qualitative insights unique to this population were identified regarding immunosuppression use and neurologic symptoms. Conclusions: MS relapses were infrequent, and there was modest progression during breast cancer treatment. Oncologic outcomes were comparable to non-MS patients with similarly staged cancer. Keywords: Multiple sclerosis, breast neoplasms, immunosuppression therapy, comorbidity, prognosis, retrospective studies, qualitative research Date received: 14 March 2023; revised: 7 April 2023; accepted: 28 April 2023 Multiple Sclerosis Journal 2023, Vol. 29(8) 967–978 DOI: 10. 1177/ 13524585231175975 © The Author(s), 2023. Article reuse guidelines: [sagepub.com/journals](sagepub.com/journals)permissions Correspondence to: R Bove Weill Institute for Neurosciences, University of California San Francisco (UCSF), 1651 4th Street, Suite 252, San Francisco, CA 94158, USA. [riley.bove@ucsf.edu](riley.bove@ucsf.edu) Alyssa N Nylander Jessica Singh Shane Poole Annika Anderson Riley Bove Weill Institute for Neurosciences, University of California San Francisco (UCSF), San Francisco, CA, USA Ruth Ann Marrie Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada Hope Rugo Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA Background Women are disproportionately affected by multiple sclerosis (MS) and breast cancer, and the intersection between these two diseases presents many challenging unanswered questions about clinical outcomes, disease trajectory, and appropriate medical management. While commonly diagnosed in young adulthood, 1 over one-third of people living with MS in the United States are post-menopausal women,2 the same population that is predominantly affected by breast cancer.3 Epidemiological studies have yielded concerning observations. While it is unclear if breast cancer incidence is greater in women with MS,4–8 they face a worse prognosis with a 28% increased hazard for all-cause mortality than the general population.9 This raises the question of whether use of immunomodulatory disease modifying therapy (DMT) for MS increases cancer risk or worsens prognosis. 10,11 Reassuringly, long-term data for one DMT of concern, ocrelizumab, do not show elevated cancer risk.12 Breast cancer screening could play a role; breast cancers in MS are less likely to be detected through screening, but delayed detection might not translate to higher cancer stage at diagnosis.13 Furthermore, the

FAQs

What question does the study address about MS and breast cancer?

It examines clinical experiences and trajectories in patients diagnosed with both MS and breast cancer, including oncologic outcomes, MS disability progression, and treatment considerations.

How was the patient cohort identified and analyzed?

Patients were identified from a single center’s electronic health record using a modified text-based search algorithm, then characterized using thematic analysis to capture experiences related to concurrent diagnoses.

What were the main findings regarding MS relapses and disability progression during breast cancer treatment?

MS relapses were infrequent, with a mean annualized relapse rate of 0.03, and Expanded Disability Status Scale (EDSS) scores remained stable during follow-up.

Sep 28, 2026

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