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J Cancer. 2017 Jul 5;8(11):2026-2032. doi: 10.7150/jca.18743. eCollection 2017.

Impact of Statin Use on Outcomes in Triple Negative Breast Cancer.

Author information

1
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
2
Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
3
Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, TX.
4
Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.

Abstract

Purpose: We sought to investigate if the use of HMG Co-A reductase inhibitors (statins) has an impact on outcomes among patients with triple negative breast cancer (TNBC). Methods: We reviewed the cases of women with invasive, non-metastatic TNBC, diagnosed 1997-2012. Clinical outcomes were compared based on statin use (defined as ever use during treatment vs. never use). We identified a subset of women for whom a 5-value lipid panel (5VLP) was available, including total cholesterol, low density lipoprotein, high density lipoprotein, very low density lipoprotein, and triglycerides. The Kaplan-Meier method was used to estimate median overall survival (OS), distant metastases-free survival (DMFS), and local-regional recurrence-free survival (LRRFS). A Cox proportional hazards regression model was used to test the statistical significance of prognostic factors. Results: 869 women were identified who met inclusion criteria, with a median follow-up time of 75.1 months (range 2.4-228.9 months). 293 (33.7%) patients used statins and 368 (42.3%) had a 5VLP. OS, DMFS, and LRRFS were not significant based on statin use or type. Controlling for the 5VLP values, on multivariable analysis, statin use was significantly associated with OS (HR 0.10, 95% CI 0.01-0.76), but not with DMFS (HR 0.14, 95% CI 0.01-1.40) nor LRRFS (HR 0.10 95% CI 0.00-3.51). Conclusions: Statin use among patients with TNBC is not associated with improved OS, although it may have a benefit for a subset of patients. Prospective assessment would be valuable to better assess the potential complex correlation between clinical outcome, lipid levels, and statin use.

KEYWORDS:

breast cancer; cholesterol; statin; triple negative

Conflict of interest statement

Competing Interests: M.C. Stauder is a consultant for the M.D. Anderson Physician's Network. The other authors have no conflicts of interest to disclose.

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