Effect of statins on breast cancer recurrence and mortality: a review

Figures & data

Table 1 Overview of the association between statin use and risk of recurrence after multivariate analysis

Study	Type	N	Stage	Statins	Recurrence
Kwan et al^Citation12	Prospective	1,945	I–IIIA	Lipophilic (97.8%)		RR	95% CI
				Hydrophilic (2.2%)	>100 days	0.67	0.39–1.13
					>2 years	0.38	0.12–1.19
Ahern et al^Citation13	Prospective	18,769	I–III	Lipophilic (77.6%), simvastatin (71.7%)		HR	95% CI
				Hydrophilic (22.3%)	5-Year lipophilic	0.7	0.53–0.92
					5-Year simvastatin	0.62	0.46–0.84
					5-Year hydrophilic	1.1	0.7–1.80
					10-Year lipophilic	0.73	0.6–0.89
					10-Year simvastatin	0.7	0.57–0.86
					10-Year hydrophilic	1.2	0.79–1.7
Chae et al^Citation15	Retrospective	703	II–III	Lipophilic (87.6%), atorvastatin (60.2%)		HR	95% CI
				Hydrophilic (12.4%)	Statins only	0.4	0.24–0.67
					Statins + ACEi/ARBs	0.3	0.15–0.61
Boudreau et al^Citation16	Prospective	4,216	I–IIB	Lipophilic, simvastatin (60.39%), fluvastatin (49.34%)		HR	95% CI
				Hydrophilic (3.63)	<1 year	0.94	0.51–1.75
					1–2.9 years	0.66	0.34–1.30
					3+ years	0.77	0.42–1.41
					Trend	0.89	0.74–1.08
Sakellakis et al^Citation17	Retrospective	610	I–III	Lipophilic (64%), atorvastatin (45%)		HR	95% CI
				Hydrophilic (16%)	All statin users	0.58	0.36–0.94
Brewer et al^Citation18	Retrospective	73	III (IBC)	Lipophilic (39.7%)		HR	95% CI
				Hydrophilic (60.3%)	Hydrophilic only	0.49	0.28–0.84
Lacerda et al^Citation39	Retrospective	53	III (IBC)			HR	95% CI
					All statin users	0.4	0.16–1.00
Manthravadi et al^Citation14	Meta-analysis	75,684; 14 studies	I–IV	All		HR	95% CI
					All statins (10 studies)	0.64	0.53–0.79
					Lipophilic (three studies)	0.72	0.59–0.89
					Hydrophilic (three studies)	0.8	0.44–1.46

Abbreviations: ACEi, angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; CI, confidence interval; HR, hazard ratio; IBC, inflammatory breast cancer; N, number; RR, relative risk.

Table 2 Overview of the association between statin use and risk of breast cancer-specific death after multivariate analysis

Study	Type	N	Stage	Statins	Risk of breast cancer death	HR	CI	Notes
Murtola et al^Citation19	Prospective	31,236	All (local vs metastatic)	Simvastatin (48.9%)	Prediagnostic statin use	0.46	0.38–0.55
				Atorvastatin (36.3%) fluvastatin (20.2%)	Postdiagnostic statin use	0.54	0.44–0.67
Cardwell et al^Citation20	Prospective	17,880	All	Not specified	All statins	0.84	0.68–1.04	Postdiagnostic
					Simvastatin only	0.79	0.63–1
Mc Menamin et al^Citation22	Prospective	15,140	All	Lipophilic (68.1%), simvastatin (67.8%)	All statins	0.95	0.79–1.15	Postdiagnostic
				Hydrophilic (35.3%)	Simvastatin only	0.89	0.73–1.08
Manthravadi et al^Citation14	Meta-analysis	75,684; 14 studies	I–IV	All	Six studies	0.7	0.46–1.06

Abbreviations: CI, confidence interval; HR, hazard ratio; N, number.

Table 3 Overview of meta-analyses carried out to determine the relationship between statins and breast cancer incidence

Study	Year	Relative risk	95% CI
Bonovas et al^Citation23	2005	1.03	0.93–1.14
Dale et al^Citation25	2006	1.02	0.97–1.07
Browning and Martin^Citation26	2007	1.01	0.79–1.3
Kuoppala et al^Citation27	2008	1.04	0.74–19
Baigent et al^Citation28	2010	1.07	0.84–1.38
Undela et al^Citation24	2012	0.99	0.94–1.04

Abbreviation: CI, confidence interval.

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