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Statin prescriptions and breast cancer recurrence risk: a Danish nationwide prospective cohort study.
J Natl Cancer Inst 2011; 103(19):1461-8JNCI

Abstract

BACKGROUND

Accumulating evidence suggests that statins affect diseases other than cardiovascular disease, including cancer, and that these effects may depend on the lipid solubility of specific statins. Though many studies have reported an association between statin use and breast cancer incidence, the relationship between statin use and breast cancer recurrence has not been well studied.

METHODS

We conducted a nationwide, population-based prospective cohort study of all female residents in Denmark diagnosed with stage I-III invasive breast carcinoma who were reported to the Danish Breast Cancer Cooperative Group registry between 1996 and 2003 (n = 18,769). Women were followed for a median of 6.8 years after diagnosis. Prescriptions for lipophilic and hydrophilic statins were ascertained from the national electronic pharmacy database. Associations between statin prescriptions and breast cancer recurrence were estimated with generalized linear models and Cox proportional hazards regression with adjustment for age and menopausal status at diagnosis; histological grade; estrogen receptor status; receipt of adjuvant therapy; type of primary surgery received; pre-diagnosis hormone replacement therapy; and co-prescriptions of aspirin, angiotensin-converting enzyme inhibitors, nonsteroidal anti-inflammatory drugs, or anticoagulants. All statistical tests were two-sided.

RESULTS

Most prescriptions for lipophilic statins in the study population were for simvastatin. Exclusive simvastatin users experienced approximately 10 fewer breast cancer recurrences per 100 women after 10 years of follow-up (adjusted 10-year risk difference = -0.10, 95% confidence interval = -0.11 to -0.08), compared with women who were not prescribed a statin. Exclusive hydrophilic statin users had approximately the same risk of breast cancer recurrence as women not prescribed a statin over follow-up (adjusted 10-year risk difference = 0.05, 95% confidence interval = -0.01 to 0.11).

CONCLUSIONS

Simvastatin, a highly lipophilic statin, was associated with a reduced risk of breast cancer recurrence among Danish women diagnosed with stage I-III breast carcinoma, whereas no association between hydrophilic statin use and breast cancer recurrence was observed.

Authors+Show Affiliations

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave, Rm 355, Boston, MA 02115, USA. nhtpa@channing.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21813413

Citation

Ahern, Thomas P., et al. "Statin Prescriptions and Breast Cancer Recurrence Risk: a Danish Nationwide Prospective Cohort Study." Journal of the National Cancer Institute, vol. 103, no. 19, 2011, pp. 1461-8.
Ahern TP, Pedersen L, Tarp M, et al. Statin prescriptions and breast cancer recurrence risk: a Danish nationwide prospective cohort study. J Natl Cancer Inst. 2011;103(19):1461-8.
Ahern, T. P., Pedersen, L., Tarp, M., Cronin-Fenton, D. P., Garne, J. P., Silliman, R. A., ... Lash, T. L. (2011). Statin prescriptions and breast cancer recurrence risk: a Danish nationwide prospective cohort study. Journal of the National Cancer Institute, 103(19), pp. 1461-8. doi:10.1093/jnci/djr291.
Ahern TP, et al. Statin Prescriptions and Breast Cancer Recurrence Risk: a Danish Nationwide Prospective Cohort Study. J Natl Cancer Inst. 2011 Oct 5;103(19):1461-8. PubMed PMID: 21813413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin prescriptions and breast cancer recurrence risk: a Danish nationwide prospective cohort study. AU - Ahern,Thomas P, AU - Pedersen,Lars, AU - Tarp,Maja, AU - Cronin-Fenton,Deirdre P, AU - Garne,Jens Peter, AU - Silliman,Rebecca A, AU - Sørensen,Henrik Toft, AU - Lash,Timothy L, Y1 - 2011/08/02/ PY - 2011/8/5/entrez PY - 2011/8/5/pubmed PY - 2011/11/11/medline SP - 1461 EP - 8 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 103 IS - 19 N2 - BACKGROUND: Accumulating evidence suggests that statins affect diseases other than cardiovascular disease, including cancer, and that these effects may depend on the lipid solubility of specific statins. Though many studies have reported an association between statin use and breast cancer incidence, the relationship between statin use and breast cancer recurrence has not been well studied. METHODS: We conducted a nationwide, population-based prospective cohort study of all female residents in Denmark diagnosed with stage I-III invasive breast carcinoma who were reported to the Danish Breast Cancer Cooperative Group registry between 1996 and 2003 (n = 18,769). Women were followed for a median of 6.8 years after diagnosis. Prescriptions for lipophilic and hydrophilic statins were ascertained from the national electronic pharmacy database. Associations between statin prescriptions and breast cancer recurrence were estimated with generalized linear models and Cox proportional hazards regression with adjustment for age and menopausal status at diagnosis; histological grade; estrogen receptor status; receipt of adjuvant therapy; type of primary surgery received; pre-diagnosis hormone replacement therapy; and co-prescriptions of aspirin, angiotensin-converting enzyme inhibitors, nonsteroidal anti-inflammatory drugs, or anticoagulants. All statistical tests were two-sided. RESULTS: Most prescriptions for lipophilic statins in the study population were for simvastatin. Exclusive simvastatin users experienced approximately 10 fewer breast cancer recurrences per 100 women after 10 years of follow-up (adjusted 10-year risk difference = -0.10, 95% confidence interval = -0.11 to -0.08), compared with women who were not prescribed a statin. Exclusive hydrophilic statin users had approximately the same risk of breast cancer recurrence as women not prescribed a statin over follow-up (adjusted 10-year risk difference = 0.05, 95% confidence interval = -0.01 to 0.11). CONCLUSIONS: Simvastatin, a highly lipophilic statin, was associated with a reduced risk of breast cancer recurrence among Danish women diagnosed with stage I-III breast carcinoma, whereas no association between hydrophilic statin use and breast cancer recurrence was observed. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/21813413/Statin_prescriptions_and_breast_cancer_recurrence_risk:_a_Danish_nationwide_prospective_cohort_study_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djr291 DB - PRIME DP - Unbound Medicine ER -