Yun Rose Li1,2, Vicky Ro3, Laura Steel3, Elena Carrigan3, Jenny Nguyen3, Austin Williams3, Alycia So3, Julia Tchou4. 1. Department of Endocrine and Oncologic Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 10th Floor South, Philadelphia, PA, 19104, USA. yun.li2@ucsf.edu. 2. Department of Radiation Oncology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, 1600 Divisadero St., Suite H1031, CA, 94143-1708, USA. yun.li2@ucsf.edu. 3. Department of Endocrine and Oncologic Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 10th Floor South, Philadelphia, PA, 19104, USA. 4. Department of Endocrine and Oncologic Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 10th Floor South, Philadelphia, PA, 19104, USA. julia.tchou@uphs.upenn.edu.
Abstract
INTRODUCTION: The use of statins has been associated with improved survival in patients with breast cancer in several studies but results have been mixed. This study evaluates the impact of duration of statin use on breast cancer patient outcomes. METHODS: This is a single-institution, retrospective cohort, examining the impact of statin use on the outcomes of 1523 women diagnosed with operable breast cancer between1995 and 2015. Clinical variables were compared using Student's t test, Fisher's exact and Chi square tests. Overall (OS) and disease-free (DFS) survival were performed using Kaplan-Meier and Cox-Proportional Hazard (Cox-PH) analysis in the statistical software R. RESULTS: Patients were grouped by duration of statin use: never-statin user [N] (n = 1092), short (< 3 years) [S] (n = 115), moderate [M] (3-5 years) (n = 109) and long [L] (> 5 years) (n = 207) term. Over a median follow-up of 70.2 months, 138 women died (84 died of breast cancer) and 125 had disease recurrence. On multivariable Cox-PH analysis adjusting for clinical variables including metabolic comorbidities using the Charlson comorbidity index, OS in the [S] and [M] subgroups did not differ [N], while OS was improved in [L] (adjusted hazard ratio (AHR) 0.38, confidence interval (CI) 0.17-0.85, p < 0.018). DFS was also significantly improved in the [L] subgroup (adjusted HR 0.15, CI 0.05-0.48, p < 0.001). Subanalysis stratified by receptor status showed a trend towards improved DFS in all tumor subtypes including triple-negative breast cancer. CONCLUSIONS: Our retrospective analyses suggest that long-term statin use (> 5 years) was associated with improved OS and DFS in women with breast cancer regardless of receptor subtype, even after adjusting for metabolic comorbidities.
INTRODUCTION: The use of statins has been associated with improved survival in patients with breast cancer in several studies but results have been mixed. This study evaluates the impact of duration of statin use on breast cancerpatient outcomes. METHODS: This is a single-institution, retrospective cohort, examining the impact of statin use on the outcomes of 1523 women diagnosed with operable breast cancer between1995 and 2015. Clinical variables were compared using Student's t test, Fisher's exact and Chi square tests. Overall (OS) and disease-free (DFS) survival were performed using Kaplan-Meier and Cox-Proportional Hazard (Cox-PH) analysis in the statistical software R. RESULTS:Patients were grouped by duration of statin use: never-statin user [N] (n = 1092), short (< 3 years) [S] (n = 115), moderate [M] (3-5 years) (n = 109) and long [L] (> 5 years) (n = 207) term. Over a median follow-up of 70.2 months, 138 women died (84 died of breast cancer) and 125 had disease recurrence. On multivariable Cox-PH analysis adjusting for clinical variables including metabolic comorbidities using the Charlson comorbidity index, OS in the [S] and [M] subgroups did not differ [N], while OS was improved in [L] (adjusted hazard ratio (AHR) 0.38, confidence interval (CI) 0.17-0.85, p < 0.018). DFS was also significantly improved in the [L] subgroup (adjusted HR 0.15, CI 0.05-0.48, p < 0.001). Subanalysis stratified by receptor status showed a trend towards improved DFS in all tumor subtypes including triple-negative breast cancer. CONCLUSIONS: Our retrospective analyses suggest that long-term statin use (> 5 years) was associated with improved OS and DFS in women with breast cancer regardless of receptor subtype, even after adjusting for metabolic comorbidities.
Entities:
Keywords:
Breast Cancer; Cancer outcomes; Cancer recurrence risk; Lipid-lowering agents; Metabolic syndrome; Statins
Authors: Nafeesa Moksud; Lenora W M Loo; Juan Yang; Chiung-Yu Huang; Christopher A Haiman; Loïc Le Marchand; Lynne R Wilkens; Iona Cheng Journal: Breast Cancer Res Treat Date: 2021-08-30 Impact factor: 4.872
Authors: Yuan Yuan; Kathy Pan; Joanne Mortimer; Rowan T Chlebowski; Juhua Luo; Jessica E Yan; Susan E Yost; Candyce H Kroenke; Lucile Adams-Campbell; Rami Nassir; Yangbo Sun; Aladdin H Shadyab; Mara Z Vitolins; Nazmus Saquib; Robert A Wild; JoAnn E Manson; Rebecca A Nelson Journal: Cancer Date: 2021-01-21 Impact factor: 6.921
Authors: Erica J Lee Argov; Teofilia Acheampong; Mary Beth Terry; Carmen B Rodriguez; Mariangela Agovino; Ying Wei; Shweta Athilat; Parisa Tehranifar Journal: Breast Cancer Res Date: 2020-09-15 Impact factor: 6.466