Antihypertensive medications and risks of recurrence and mortality in luminal, triple-negative, and HER2-overexpressing breast cancer

Loroña, Nicole C.; Cook, Linda S.; Tang, Minh; Hill, Deirdre A.; Wiggins, Charles L.; Li, Christopher I.

doi:10.1007/s10552-021-01485-3

Cited by 6 publications

(11 citation statements)

References 35 publications

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“… Comparison group is users of other antihypertensive medications in the study by Lorona et al [ 19 ] and in our original cohort study, and all non-users of β-blockers in the other studies. HR hazard ratio, CI confidence interval, ER oestrogen receptor, PR progesterone receptor, HER2 human epidermal growth factor receptor 2, RE random effect, TNBC triple-negative breast cancer.…”

Section: Resultsmentioning

confidence: 99%

“…In a sensitivity analysis we changed the estimates from the study by Lorona et al [ 19 ] and from the original cohort study reported here to estimates that compared users of β-blockers to all non-users of β-blockers, while the estimates from the other studies remained the same (i.e. having all non-users of β-blockers as comparison group).…”

Section: Resultsmentioning

confidence: 99%

“…The results of an association between use of β-blockers and improved BC-specific survival for patients with TNBC in our study are also in line with a previous meta-analysis that focused on patients with early BC only [ 57 ]. However, two studies did not find an association in TNBC patients [ 19 , 20 ]. Santala et al found an indication of improved BC-specific survival (HR = 0.79, 95% CI: 0.50–1.25) [ 20 ], while Lorona et al reported HRs of 1.10 (95% CI: 0.60–2.00) for RFS and 1.10 (95% CI: 0.70–1.90) for BC-specific survival [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the case of multiple estimates of the same association, we chose the estimate deriving from the most adjusted model. Therefore, for the original cohort study reported here and the study by Lorona et al [ 19 ] we used the estimates that compared users of β-blockers to users of other antihypertensive medications, because those estimates took into account the potential effect of hypertension. The estimates from the other studies used all non-users of β-blockers as comparison group.…”

Section: Methodsmentioning

confidence: 99%

“…In a sensitivity analysis, we changed the estimates for the original cohort study reported here and the study by Lorona et al [ 19 ] to estimates that compared users of β-blockers to all non-users of β-blockers, while the estimates from the other studies remained the same.…”

Section: Methodsmentioning

confidence: 99%

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β-blockers and breast cancer survival by molecular subtypes: a population-based cohort study and meta-analysis

et al. 2022

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Background The association between use of β-blockers and breast cancer (BC) prognosis has been investigated in several observational studies, with conflicting results. We performed a nationwide cohort study and a meta-analysis to investigate the association, and assess if it varied between molecular subtypes of BC. Methods We identified women aged ≥50 years with BC diagnosed between 2004 and 2018 in Norway. We used Cox regression models to estimate the association between β-blocker use at diagnosis and BC-specific survival, overall and by molecular subtype. We performed a meta-analysis of observational studies that reported molecular subtype-specific estimates of this association. Results We included 30,060 women, of which 4461 (15%) used β-blockers. After a median follow-up of 5.1 years, 2826 (9%) died of BC. Overall, β-blocker use was not associated with BC-specific survival (hazard ratio [HR] = 1.07; 95% confidence interval [CI]: 0.97–1.19). We found an association only in triple-negative BC (TNBC) patients (HR = 0.66; 95% CI: 0.47–0.91). This was confirmed in the meta-analysis: β-blocker use was associated with progression/recurrence-free (HR = 0.58; 95% CI: 0.38–0.89) and BC-specific survival (HR = 0.74; 95% CI: 0.55–1.00) in TNBC patients only. Conclusion In our cohort of BC patients and in the meta-analysis, β-blocker use was associated with prolonged BC-specific survival only in TNBC patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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β-blockers and breast cancer survival by molecular subtypes: a population-based cohort study and meta-analysis

et al. 2022

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Beta-blocker use and breast cancer outcomes: a meta-analysis

Scott,

TinTin,

Cavadino

et al. 2024

Breast Cancer Res Treat

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Purpose Beta blockers (BBs) are commonly used cardiovascular medications, and their association with breast cancer outcomes has been examined in several previous observational studies and meta-analyses. In this study, an updated meta-analysis was undertaken to ascertain the association between BBs and both breast cancer death (BCD) and breast cancer recurrence (BCR). Methods Articles were sourced from various databases up until the 14th of August 2023. Effect estimates were pooled using the random effects model, and the Higgins I2 statistic was computed to ascertain heterogeneity. Subgroup analyses were conducted by the potential for immortal time bias (ITB), the exposure period (prediagnosis vs postdiagnosis), and type of BB (selective vs non-selective). Publication bias was assessed using funnel plots and Egger’s regression tests. Results Twenty-four studies were included. Pooled results showed that there was no statistically significant association between BB use and both BCD (19 studies, hazard ratio = 0.90, 95% CI 0.78–1.04) and BCR (16 studies, HR = 0.87, 95% CI 0.71–1.08). After removing studies with ITB, the associations were attenuated towards the null. There was no effect modification for either outcome when stratifying by the exposure period or type of BB. There was clear evidence of publication bias for both outcomes. Conclusion In this meta-analysis, we found no evidence of an association between BB use and both BCD and BCR. Removing studies with ITB attenuated the associations towards the null, but there was no effect modification by the exposure period or type of BB.

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