Statin use and breast cancer risk

Statins are a widely prescribed, effective cholesterol-lowering remedy The statins are pleiotropic agents, and, after an early close attention of patients with coronary heart disease showed a lower than awaited incidence of cancers, preclinical studies were carried without that have supported the potential anticancer activity of these mingles However, clinical reports on the relationship between statin use and breast cancer risk have yielded mixed be deriveds with no association and one as well as the other positive and negative associations being observed

A new investigation set out to examine the associations between the efficacy duration, and type of statin used and invasive breast cancer risk among women registered in the Women's Health Initiative (WHI). A secondary objective was to assess the association between use of other lipid-lowering agents and breast cancer.

The WHI includes an observational application of mind (n = 93,676) and clinical trials (n = 68132) of hormone therapy, dietary modification, and/or calcium and vitamin D supplementation in postmenopausal women of many races and ethnicities. subdues were aged 50 yrs to 79 yr and were postmenopausal. This analysis included women enlisted in the observational study and clinical trial constituents of the WHI, excluding those who had previously been diagnosed with breast cancer or who had used tamoxifen or any selective estrogen receptor modulator. The final sample included 88322 women listed in the observational study and 68029 women enlisted in the clinical trials (156351 women total).

subdues were asked to bring all rife prescription medications to their first screening interview. Women reported duration of use for each medication. in every one's mouth medication use was updated at the year 3 clinic visit. common statin use was defined as use of any 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor. Statins were further classified as hydrophobic (lovastatin, simvastatin, and fluvastatin) or other (pravastatin and atorvastatin) and by dint of potency: low (fluvastatin and lovastatin), medium (pravastatin), and high (simvastatin and atorvastatin).

Medical history was updated annually or semiannually. For women in the clinical trial constitutings of the WHI, the oftenness of clinical breast examination and mammography was protocol defined (annually for women in the hormone trials and biennially for women in the diary trial). Clinical breast examination and mammography were not protocol defined for women in the observational close attention Only invasive breast cancer cases confirmed by the agency of adjudication were included in the analysis. Information upon all covariates was collected at application of mind entry.

Over an average follow-up of 67 years, 4383 invasive breast cancers were confirmed by means of medical record and pathology report review. Statins were used by dint of 11,710 (7.5%) of the cohort. Breast cancer incidence was 409 through 1000 person-years (PY) among statin users and 428 through 1000 PY among nonusers. In multivariable types the hazard ratio (HR) of breast cancer among users of any statin, compared with nonusers, was 091 (95% CI = 080 to 105 P = 20) There was no run in risk by duration of statin use, HR = 080 (95% CI = 063 to 103) for <1 year of use; HR = 090 (95% CI = 080 to 123) for 1-<3 years of use; and HR = 094 (95% CI = 075 to 118) for HR e" 3 years of use. Hydrophobic statins (that is, simvastatin, lovastatin, and fluvastatin) were used by dint of 8106 women, and their use was associated with an 18% lower breast cancer incidence (HR = 082 95% CI = 070 to 097 P = 02) Use of other statins or nonstatin lipid-lowering agents was not associated with breast cancer incidence.

Overall, it appears that statin use is not associated with invasive breast cancer. The finding that use of hydrophobic statins may be associated with lower breast cancer incidence glance ats possible within-class differences that may warrant further investigation.

J Cauley, A. McTiernan, R Rodabough, et al. Statin use and breast cancer: Prospective arises from the Women's Health Initiative. J Natl Cancer Inst; 98:700-707 (May 17 2006) [Correspondence: Jane A. Cauley, DrPH University of Pittsburgh, 130 DeSoto St Crabtree Hall A524, Pittsburgh, PA 15261 E-mail: jcauley@pitt.edu]

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