Division of Oncology and Pathology, Department of Clinical Sciences, Barngatan 4, SE-221 85, Lund, Sweden.
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
BMC Cancer. 2019 Jan 11;19(1):54. doi: 10.1186/s12885-018-5263-z.
A sizeable body of evidence suggests that statins can cease breast cancer progression and prevent breast cancer recurrence. The latest studies have, however, not been supportive of such clinically beneficial effects. These discrepancies may be explained by insufficient power. This considerably sized study investigates the association between both pre- and post-diagnostic statin use and breast cancer outcome.
A Swedish nation-wide retrospective cohort study of 20,559 Swedish women diagnosed with breast cancer (July 1st, 2005 through 2008). Dispensed statin medication was identified through the Swedish Prescription Registry. Breast cancer related death information was obtained from the national cause-of-death registry until December 31st, 2012. Cox regression models yielded hazard ratios (HR) and 95% confidence intervals (CI) regarding associations between statin use and breast cancer-specific and overall mortality.
During a median follow-up time of 61.6 months, a total of 4678 patients died, of which 2669 were considered breast cancer related deaths. Compared to non- or irregular use, regular pre-diagnostic statin use was associated with lower risk of breast cancer related deaths (HR = 0.77; 95% CI 0.63-0.95, P = 0.014). Similarly, post-diagnostic statin use compared to non-use was associated with lower risk of breast cancer related deaths (HR = 0.83; 95% CI 0.75-0.93, P = 0.001).
This study supports the notion that statin use is protective regarding breast cancer related mortality in agreement with previous Scandinavian studies, although less so with studies in other populations. These disparities should be further investigated to pave the way for future randomized clinical trials investigating the role of statins in breast cancer.
大量证据表明,他汀类药物可以阻止乳腺癌的进展并预防乳腺癌的复发。然而,最新的研究并不支持这种具有临床益处的作用。这些差异可能是由于效力不足所致。这项规模较大的研究调查了诊断前和诊断后使用他汀类药物与乳腺癌结局之间的关系。
这是一项瑞典全国性的回顾性队列研究,纳入了 20559 名瑞典女性乳腺癌患者(2005 年 7 月 1 日至 2008 年)。通过瑞典处方登记处确定开具的他汀类药物。通过全国死因登记处获得乳腺癌相关死亡信息,直至 2012 年 12 月 31 日。Cox 回归模型得出了他汀类药物使用与乳腺癌特异性和总体死亡率之间关联的风险比(HR)和 95%置信区间(CI)。
在中位随访时间为 61.6 个月期间,共有 4678 名患者死亡,其中 2669 例被认为与乳腺癌相关。与非或不规则使用相比,常规诊断前使用他汀类药物与乳腺癌相关死亡率降低相关(HR=0.77;95%CI 0.63-0.95,P=0.014)。同样,与非使用相比,诊断后使用他汀类药物与乳腺癌相关死亡率降低相关(HR=0.83;95%CI 0.75-0.93,P=0.001)。
这项研究支持他汀类药物使用对乳腺癌相关死亡率具有保护作用的观点,与先前的斯堪的纳维亚研究一致,尽管与其他人群的研究相比,这种作用较弱。这些差异应进一步研究,为未来调查他汀类药物在乳腺癌中的作用的随机临床试验铺平道路。