Department of Immunology, Genetics, and Pathology, Uppsala University, Dag Hammarskjölds Väg 20, 751 85, Uppsala, Sweden.
Department of Clinical Medicine, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.
Breast Cancer Res Treat. 2024 Sep;207(2):293-299. doi: 10.1007/s10549-024-07358-y. Epub 2024 May 19.
Retrospective observational studies suggest a potential role of beta-blockers as a protective strategy against progression and metastasis in invasive breast cancer. In this context, we investigated the impact of beta-blocker exposure on risk for progression to invasive breast cancer after diagnosis of ductal cancer in situ (DCIS).
The retrospective study population included 2535 women diagnosed with pure DCIS between 2006 and2012 in three healthcare regions in SwedenExposure to beta-blocker was quantified using a time-varying percentage of days with medication available. The absolute risk was quantified using cumulative incidence functions and cox models were applied to quantify the association between beta-blocker exposure and time from DCIS diagnosis to invasive breast cancer, accounting for delayed effects, competing risks and pre-specified confounders.
The median follow-up was 8.7 years. One third of the patients in our cohort were exposed to beta-blockers post DCIS diagnosis. During the study period, 48 patients experienced an invasive recurrence, giving a cumulative incidence of invasive breast cancer progression of 1.8% at five years. The cumulative exposure to beta-blocker was associated with a reduced risk in a dose-dependent manner, though the effect was not statistically significant.
Our observational study is suggestive of a protective effect of beta-blockers against invasive breast cancer after primary DCIS diagnosis. These results provide rationales for experimental and clinical follow-up studies in carefully selected DCIS groups.
回顾性观察研究表明，β受体阻滞剂可能作为一种保护策略，预防浸润性乳腺癌的进展和转移。在此背景下，我们研究了β受体阻滞剂暴露对导管原位癌（DCIS）诊断后浸润性乳腺癌进展风险的影响。
该回顾性研究的研究人群包括 2006 年至 2012 年期间在瑞典三个医疗保健地区诊断为单纯 DCIS 的 2535 名女性。使用药物可用天数的时变百分比来量化β受体阻滞剂的暴露。使用累积发生率函数量化绝对风险，并应用 Cox 模型量化β受体阻滞剂暴露与从 DCIS 诊断到浸润性乳腺癌的时间之间的关联，同时考虑到延迟效应、竞争风险和预先指定的混杂因素。
中位随访时间为 8.7 年。我们队列中的三分之一患者在 DCIS 诊断后接受了β受体阻滞剂治疗。在研究期间，48 名患者发生浸润性复发，五年时浸润性乳腺癌进展的累积发生率为 1.8%。β受体阻滞剂的累积暴露与风险呈剂量依赖性降低，但无统计学意义。
我们的观察性研究提示，β受体阻滞剂对原发性 DCIS 诊断后浸润性乳腺癌具有保护作用。这些结果为在精心挑选的 DCIS 患者群体中进行实验和临床随访研究提供了依据。
