Statin use and breast cancer: Prospective results from the women's health initiative

Jane A. Cauley; Anne McTiernan; Rebecca J. Rodabough; Andrea LaCroix; Douglas C. Bauer; Karen L. Margolis; Electra D. Paskett; Mara Z. Vitolins; Curt D. Furberg; Rowan T. Chlebowski; Barbara Alving; Jacques Rossouw; Linda Pottern; Ross Prentice; Garnet Anderson; Charles L. Kooperberg; Ruth E. Patterson; Sally Shumaker; Evan Stein; Steven Cummings; Sylvia Wassertheil-Smoller; Jennifer Hays; Jo Ann Manson; Annlouise R. Assaf; Lawrence Phillips; Shirley Beresford; Judith Hsia; Evelyn Whitlock; Bette Caan; Jane Morley Kochen; Barbara V. Howard; Linda Van Horn; Henry Black; Marcia L. Stefanick; Dorothy Lane; Rebecca Jackson; Cora E. Lewis; Tamsen Bassford; Jean Wactawski-Wende; John Robbins; Allan Hubbell; Howard Judd; Robert D. Langer; Margery Gass; Marian Limacher; David Curb; Robert Wallace; Judith Ockene; Norman Lasser; Mary Jo O'Sullivan; Robert Brunner; Gerardo Heiss; Lewis Kuller; Karen C. Johnson; Robert Brzyski; Gloria E. Sarto; Denise Bonds; Susan Hendrix

doi:10.1093/jnci/djj188

Statin use and breast cancer: Prospective results from the women's health initiative

Jane A. Cauley, Anne McTiernan, Rebecca J. Rodabough, Andrea LaCroix, Douglas C. Bauer, Karen L. Margolis, Electra D. Paskett, Mara Z. Vitolins, Curt D. Furberg, Rowan T. Chlebowski, Barbara Alving, Jacques Rossouw, Linda Pottern, Ross Prentice, Garnet Anderson, Charles L. Kooperberg, Ruth E. Patterson, Sally Shumaker, Evan Stein, Steven CummingsSylvia Wassertheil-Smoller, Jennifer Hays, Jo Ann Manson, Annlouise R. Assaf, Lawrence Phillips, Shirley Beresford, Judith Hsia, Evelyn Whitlock, Bette Caan, Jane Morley Kochen, Barbara V. Howard, Linda Van Horn, Henry Black, Marcia L. Stefanick, Dorothy Lane, Rebecca Jackson, Cora E. Lewis, Tamsen Bassford, Jean Wactawski-Wende, John Robbins, Allan Hubbell, Howard Judd, Robert D. Langer, Margery Gass, Marian Limacher, David Curb, Robert Wallace, Judith Ockene, Norman Lasser, Mary Jo O'Sullivan, Robert Brunner, Gerardo Heiss, Lewis Kuller, Karen C. Johnson, Robert Brzyski, Gloria E. Sarto, Denise Bonds, Susan Hendrix

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Abstract

Background: Despite experimental observations suggesting that 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) have antitumor activity, clinical studies have reached mixed conclusions about the relationship between statin use and breast cancer risk. Methods: To investigate associations between potency, duration of use, and type of statin used and risk of invasive breast cancer, we examined data for 156 351 postmenopausal women who were enrolled in the Women's Health Initiative. Information was collected on breast cancer risk factors and on the use of statins and other lipid-lowering drugs. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Statistical tests were two-sided. Results: Over an average follow-up of 6.7 years, 4383 invasive breast cancers were confirmed by medical record and pathology report review. Statins were used by 11 710 (7.5%) of the cohort. Breast cancer incidence was 4.09 per 1000 person-years (PY) among statin users and 4.28 per 1000 PY among nonusers. In multivariable models, the hazard ratio of breast cancer among users of any statin, compared with nonusers, was 0.91 (95% CI = 0.80 to 1.05, P = .20). There was no trend in risk by duration of statin use, with HR = 0.80 (95% CI = 0.63 to 1.03) for <1 year of use, HR = 0.99 (95% CI = 0.80 to 1.23) for 1-<3 years of use, and HR = 0.94 (95% CI = 0.75 to 1.18) for ≥3 years of use. Hydrophobic statins (i.e., simvastatin, lovastatin, and fluvastatin) were used by 8106 women, and their use was associated with an 18% lower breast cancer incidence (HR = 0.82, 95% CI = 0.70 to 0.97, P = .02). Use of other statins (i.e., pravastatin and atorvastatin) or nonstatin lipid-lowering agents was not associated with breast cancer incidence. Conclusions: Overall statin use was not associated with invasive breast cancer incidence. Our finding that use of hydrophobic statins may be associated with lower breast cancer incidence suggests possible within-class differences that warrant further evaluation.

Original language	English
Pages (from-to)	700-707
Number of pages	8
Journal	Journal of the National Cancer Institute
Volume	98
Issue number	10
DOIs	https://doi.org/10.1093/jnci/djj188
State	Published - 17 May 2006

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Cauley, J. A., McTiernan, A., Rodabough, R. J., LaCroix, A., Bauer, D. C., Margolis, K. L., Paskett, E. D., Vitolins, M. Z., Furberg, C. D., Chlebowski, R. T., Alving, B., Rossouw, J., Pottern, L., Prentice, R., Anderson, G., Kooperberg, C. L., Patterson, R. E., Shumaker, S., Stein, E., ... Hendrix, S. (2006). Statin use and breast cancer: Prospective results from the women's health initiative. Journal of the National Cancer Institute, 98(10), 700-707. https://doi.org/10.1093/jnci/djj188

@article{796db20a905c492d907bc66433bca784,

title = "Statin use and breast cancer: Prospective results from the women's health initiative",

abstract = "Background: Despite experimental observations suggesting that 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) have antitumor activity, clinical studies have reached mixed conclusions about the relationship between statin use and breast cancer risk. Methods: To investigate associations between potency, duration of use, and type of statin used and risk of invasive breast cancer, we examined data for 156 351 postmenopausal women who were enrolled in the Women's Health Initiative. Information was collected on breast cancer risk factors and on the use of statins and other lipid-lowering drugs. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Statistical tests were two-sided. Results: Over an average follow-up of 6.7 years, 4383 invasive breast cancers were confirmed by medical record and pathology report review. Statins were used by 11 710 (7.5%) of the cohort. Breast cancer incidence was 4.09 per 1000 person-years (PY) among statin users and 4.28 per 1000 PY among nonusers. In multivariable models, the hazard ratio of breast cancer among users of any statin, compared with nonusers, was 0.91 (95% CI = 0.80 to 1.05, P = .20). There was no trend in risk by duration of statin use, with HR = 0.80 (95% CI = 0.63 to 1.03) for <1 year of use, HR = 0.99 (95% CI = 0.80 to 1.23) for 1-<3 years of use, and HR = 0.94 (95% CI = 0.75 to 1.18) for ≥3 years of use. Hydrophobic statins (i.e., simvastatin, lovastatin, and fluvastatin) were used by 8106 women, and their use was associated with an 18% lower breast cancer incidence (HR = 0.82, 95% CI = 0.70 to 0.97, P = .02). Use of other statins (i.e., pravastatin and atorvastatin) or nonstatin lipid-lowering agents was not associated with breast cancer incidence. Conclusions: Overall statin use was not associated with invasive breast cancer incidence. Our finding that use of hydrophobic statins may be associated with lower breast cancer incidence suggests possible within-class differences that warrant further evaluation.",

author = "Cauley, {Jane A.} and Anne McTiernan and Rodabough, {Rebecca J.} and Andrea LaCroix and Bauer, {Douglas C.} and Margolis, {Karen L.} and Paskett, {Electra D.} and Vitolins, {Mara Z.} and Furberg, {Curt D.} and Chlebowski, {Rowan T.} and Barbara Alving and Jacques Rossouw and Linda Pottern and Ross Prentice and Garnet Anderson and Kooperberg, {Charles L.} and Patterson, {Ruth E.} and Sally Shumaker and Evan Stein and Steven Cummings and Sylvia Wassertheil-Smoller and Jennifer Hays and Manson, {Jo Ann} and Assaf, {Annlouise R.} and Lawrence Phillips and Shirley Beresford and Judith Hsia and Evelyn Whitlock and Bette Caan and Kochen, {Jane Morley} and Howard, {Barbara V.} and {Van Horn}, Linda and Henry Black and Stefanick, {Marcia L.} and Dorothy Lane and Rebecca Jackson and Lewis, {Cora E.} and Tamsen Bassford and Jean Wactawski-Wende and John Robbins and Allan Hubbell and Howard Judd and Langer, {Robert D.} and Margery Gass and Marian Limacher and David Curb and Robert Wallace and Judith Ockene and Norman Lasser and O'Sullivan, {Mary Jo} and Robert Brunner and Gerardo Heiss and Lewis Kuller and Johnson, {Karen C.} and Robert Brzyski and Sarto, {Gloria E.} and Denise Bonds and Susan Hendrix",

year = "2006",

month = may,

day = "17",

doi = "10.1093/jnci/djj188",

language = "English",

volume = "98",

pages = "700--707",

journal = "Journal of the National Cancer Institute",

issn = "0027-8874",

publisher = "Oxford University Press",

number = "10",

}

Cauley, JA, McTiernan, A, Rodabough, RJ, LaCroix, A, Bauer, DC, Margolis, KL, Paskett, ED, Vitolins, MZ, Furberg, CD, Chlebowski, RT, Alving, B, Rossouw, J, Pottern, L, Prentice, R, Anderson, G, Kooperberg, CL, Patterson, RE, Shumaker, S, Stein, E, Cummings, S, Wassertheil-Smoller, S, Hays, J, Manson, JA, Assaf, AR, Phillips, L, Beresford, S, Hsia, J, Whitlock, E, Caan, B, Kochen, JM, Howard, BV, Van Horn, L, Black, H, Stefanick, ML, Lane, D, Jackson, R, Lewis, CE, Bassford, T, Wactawski-Wende, J, Robbins, J, Hubbell, A, Judd, H, Langer, RD, Gass, M, Limacher, M, Curb, D, Wallace, R, Ockene, J, Lasser, N, O'Sullivan, MJ, Brunner, R, Heiss, G, Kuller, L, Johnson, KC, Brzyski, R, Sarto, GE, Bonds, D & Hendrix, S 2006, 'Statin use and breast cancer: Prospective results from the women's health initiative', Journal of the National Cancer Institute, vol. 98, no. 10, pp. 700-707. https://doi.org/10.1093/jnci/djj188

TY - JOUR

T1 - Statin use and breast cancer

T2 - Prospective results from the women's health initiative

AU - Cauley, Jane A.

AU - McTiernan, Anne

AU - Rodabough, Rebecca J.

AU - LaCroix, Andrea

AU - Bauer, Douglas C.

AU - Margolis, Karen L.

AU - Paskett, Electra D.

AU - Vitolins, Mara Z.

AU - Furberg, Curt D.

AU - Chlebowski, Rowan T.

AU - Alving, Barbara

AU - Rossouw, Jacques

AU - Pottern, Linda

AU - Prentice, Ross

AU - Anderson, Garnet

AU - Kooperberg, Charles L.

AU - Patterson, Ruth E.

AU - Shumaker, Sally

AU - Stein, Evan

AU - Cummings, Steven

AU - Wassertheil-Smoller, Sylvia

AU - Hays, Jennifer

AU - Manson, Jo Ann

AU - Assaf, Annlouise R.

AU - Phillips, Lawrence

AU - Beresford, Shirley

AU - Hsia, Judith

AU - Whitlock, Evelyn

AU - Caan, Bette

AU - Kochen, Jane Morley

AU - Howard, Barbara V.

AU - Van Horn, Linda

AU - Black, Henry

AU - Stefanick, Marcia L.

AU - Lane, Dorothy

AU - Jackson, Rebecca

AU - Lewis, Cora E.

AU - Bassford, Tamsen

AU - Wactawski-Wende, Jean

AU - Robbins, John

AU - Hubbell, Allan

AU - Judd, Howard

AU - Langer, Robert D.

AU - Gass, Margery

AU - Limacher, Marian

AU - Curb, David

AU - Wallace, Robert

AU - Ockene, Judith

AU - Lasser, Norman

AU - O'Sullivan, Mary Jo

AU - Brunner, Robert

AU - Heiss, Gerardo

AU - Kuller, Lewis

AU - Johnson, Karen C.

AU - Brzyski, Robert

AU - Sarto, Gloria E.

AU - Bonds, Denise

AU - Hendrix, Susan

PY - 2006/5/17

Y1 - 2006/5/17

N2 - Background: Despite experimental observations suggesting that 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) have antitumor activity, clinical studies have reached mixed conclusions about the relationship between statin use and breast cancer risk. Methods: To investigate associations between potency, duration of use, and type of statin used and risk of invasive breast cancer, we examined data for 156 351 postmenopausal women who were enrolled in the Women's Health Initiative. Information was collected on breast cancer risk factors and on the use of statins and other lipid-lowering drugs. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Statistical tests were two-sided. Results: Over an average follow-up of 6.7 years, 4383 invasive breast cancers were confirmed by medical record and pathology report review. Statins were used by 11 710 (7.5%) of the cohort. Breast cancer incidence was 4.09 per 1000 person-years (PY) among statin users and 4.28 per 1000 PY among nonusers. In multivariable models, the hazard ratio of breast cancer among users of any statin, compared with nonusers, was 0.91 (95% CI = 0.80 to 1.05, P = .20). There was no trend in risk by duration of statin use, with HR = 0.80 (95% CI = 0.63 to 1.03) for <1 year of use, HR = 0.99 (95% CI = 0.80 to 1.23) for 1-<3 years of use, and HR = 0.94 (95% CI = 0.75 to 1.18) for ≥3 years of use. Hydrophobic statins (i.e., simvastatin, lovastatin, and fluvastatin) were used by 8106 women, and their use was associated with an 18% lower breast cancer incidence (HR = 0.82, 95% CI = 0.70 to 0.97, P = .02). Use of other statins (i.e., pravastatin and atorvastatin) or nonstatin lipid-lowering agents was not associated with breast cancer incidence. Conclusions: Overall statin use was not associated with invasive breast cancer incidence. Our finding that use of hydrophobic statins may be associated with lower breast cancer incidence suggests possible within-class differences that warrant further evaluation.

AB - Background: Despite experimental observations suggesting that 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) have antitumor activity, clinical studies have reached mixed conclusions about the relationship between statin use and breast cancer risk. Methods: To investigate associations between potency, duration of use, and type of statin used and risk of invasive breast cancer, we examined data for 156 351 postmenopausal women who were enrolled in the Women's Health Initiative. Information was collected on breast cancer risk factors and on the use of statins and other lipid-lowering drugs. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Statistical tests were two-sided. Results: Over an average follow-up of 6.7 years, 4383 invasive breast cancers were confirmed by medical record and pathology report review. Statins were used by 11 710 (7.5%) of the cohort. Breast cancer incidence was 4.09 per 1000 person-years (PY) among statin users and 4.28 per 1000 PY among nonusers. In multivariable models, the hazard ratio of breast cancer among users of any statin, compared with nonusers, was 0.91 (95% CI = 0.80 to 1.05, P = .20). There was no trend in risk by duration of statin use, with HR = 0.80 (95% CI = 0.63 to 1.03) for <1 year of use, HR = 0.99 (95% CI = 0.80 to 1.23) for 1-<3 years of use, and HR = 0.94 (95% CI = 0.75 to 1.18) for ≥3 years of use. Hydrophobic statins (i.e., simvastatin, lovastatin, and fluvastatin) were used by 8106 women, and their use was associated with an 18% lower breast cancer incidence (HR = 0.82, 95% CI = 0.70 to 0.97, P = .02). Use of other statins (i.e., pravastatin and atorvastatin) or nonstatin lipid-lowering agents was not associated with breast cancer incidence. Conclusions: Overall statin use was not associated with invasive breast cancer incidence. Our finding that use of hydrophobic statins may be associated with lower breast cancer incidence suggests possible within-class differences that warrant further evaluation.

UR - http://www.scopus.com/inward/record.url?scp=33646949251&partnerID=8YFLogxK

U2 - 10.1093/jnci/djj188

DO - 10.1093/jnci/djj188

M3 - Article

C2 - 16705124

AN - SCOPUS:33646949251

SN - 0027-8874

VL - 98

SP - 700

EP - 707

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

IS - 10

ER -

Statin use and breast cancer: Prospective results from the women's health initiative

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