Statin use after but not before breast cancer diagnosis is associated with improved mortality in hormone receptor-positive early breast cancer

1. Prediagnostic statin use was not associated with higher survival among patients with early breast cancer.

2. Postdiagnostic statin use was associated with lower all-cause and breast cancer–specific mortality among early breast cancer patients with hormone receptor–positive intrinsic subtypes.

Evidence Rating Level: 2 (Good)

Although statins are commonly prescribed drugs to reduce the risk of cardiovascular diseases, there is evidence that statin use before or after breast cancer diagnosis is associated with improved survival in patients with breast cancer. However, research on outcomes of statin use in patients with different intrinsic breast cancer subtypes is lacking. This study thus examined the associations between prediagnostic and postdiagnostic statin use and survival in patients with early breast cancer of different intrinsic subtypes. This retrospective population-based cohort study used data from Finnish national registries and included female patients with invasive breast cancer diagnosed in Finland between 1995 and 2013. The primary outcomes were all-cause and breast cancer–specific mortality during follow-up. In total, 7,389 female patients with early breast cancer were included in the study (median [range] age at diagnosis, 60 [21-102] years). Prediagnostic statin use was not associated with breast cancer–specific or all-cause mortality. Independent of blood cholesterol levels, postdiagnostic statin was associated with lower breast cancer–specific (adjusted hazard ratio [aHR], 0.59; 95% CI, 0.48-0.71) and all-cause (aHR, 0.68; 95% CI, 0.61-0.76) mortality in the whole cohort. Postdiagnostic statin use was also associated with higher breast cancer–specific survival in all hormone receptor–positive subtypes (luminal A-like, luminal B-like [HER2-negative], and luminal B-like [HER2-positive]). Furthermore, postdiagnostic statin use was associated with lower all-cause mortality among statin users in patients with hormone receptor–positive and triple-negative subtypes. Overall, this study found that prediagnostic statin use was not associated with higher survival, while postdiagnostic statin use was associated with lower all-cause and breast cancer–specific mortality among early breast cancer patients with hormone receptor–positive intrinsic subtypes. These results suggest that statin therapy may be more beneficial for patients with early hormone receptor–positive subtypes.

Click here to read this study in JAMA Network Open

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