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Area of Science:

  • Oncology
  • Pharmacology
  • Epidemiology

Background:

  • Cholesterol metabolism is increasingly implicated in breast cancer (BC) progression.
  • Cholesterol-lowering medications, specifically statins, may offer prognostic benefits for BC patients.

Purpose of the Study:

  • To investigate the association between initiating statin use after a breast cancer diagnosis and BC mortality.
  • To evaluate statins' impact on overall survival in early-stage BC patients using an emulated target trial design.

Main Methods:

  • An observational cohort study utilized a target trial framework with data from Danish registries (2000-2021).
  • Included 66,952 women with stage I-III BC, excluding those with prior BC or prediagnosis statin use.
  • Emulated trial compared statin initiation within 36 months postdiagnosis versus no statin initiation, using inverse probability of censoring weighted (IPCW) Cox regression.

Main Results:

  • Over 606,266 person-years, 7.2% of patients initiated statins postdiagnosis.
  • The 10-year BC mortality risk was 11.8% for statin initiators vs. 13.5% for non-initiators (risk difference: 1.7%).
  • Initiating statins was associated with a reduced hazard ratio (HR) for BC mortality (0.90) and all-cause mortality (0.92).

Conclusions:

  • Postdiagnosis statin initiation showed a modest association with reduced breast cancer and all-cause mortality in early-stage BC.
  • These findings support exploring statins as a potential adjunct therapy to standard adjuvant breast cancer treatment.