BackgroundPreclinical evidence suggests improved breast cancer survival associated with statin use, but findings from observational studies are conflicting and remain inconclusive. The objective of this study was to assess the association between statin use after cancer diagnosis and cancer outcomes among breast cancer patients.MethodsIn this retrospective cohort study, 38,858 women aged ≥66 years who were diagnosed with localized and regional stage breast cancer from 2008 through 2017 were identified from the linked Surveillance, Epidemiology, and End Results Medicare database. Statin use was ascertained from Medicare Part D pharmacy claims data. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between post‐diagnosis statin use and risks of breast cancer recurrence and breast cancer–specific mortality.ResultsOver a median follow‐up of 2.9 years for recurrence and 3.7 years for mortality, 1446 women experienced a recurrence, and 2215 died from breast cancer. The mean duration of post‐diagnosis statin use was 2.2 years. Statin use post‐diagnosis was not associated with recurrence risk (HR, 1.05; 95% CI, 0.91–1.21), but was associated with a reduced risk of cancer‐specific mortality (HR, 0.85; 95% CI, 0.75–0.96). The reduction was more pronounced in women with hormone receptor–positive/human epidermal growth factor receptor 2–negative breast cancer (HR, 0.71; 95% CI, 0.57–0.88).ConclusionsThese findings suggest that post‐diagnosis statin use is associated with improved cancer‐specific survival in women with breast cancer and should be confirmed in randomized trials of statin therapy in breast cancer patients.

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他汀类药物的使用以及乳腺癌复发和死亡的风险

背景临床前证据表明，使用他汀类药物可以改善乳腺癌的生存率，但观察性研究的结果是相互矛盾的，并且仍然没有结论。本研究的目的是评估乳腺癌患者癌症诊断后使用他汀类药物与癌症结局之间的关联。方法在这项回顾性队列研究中，2008 年至 2017 年期间，有 38,858 名年龄≥66 岁的女性被诊断患有局部和区域期乳腺癌。是从链接的监测、流行病学和最终结果医疗保险数据库中确定的。他汀类药物的使用情况是根据 Medicare D 部分药房索赔数据确定的。使用多变量 Cox 比例风险模型来估计诊断后他汀类药物使用与乳腺癌复发风险和乳腺癌特异性死亡率之间关联的风险比 (HR) 和 95% 置信区间 (CI)。结果中位随访复发时间为 2.9 年，死亡率为 3.7 年，1446 名女性经历了复发，2215 人死于乳腺癌。诊断后他汀类药物的平均使用时间为 2.2 年。诊断后使用他汀类药物与复发风险无关（HR，1.05；95% CI，0.91-1.21），但与癌症特异性死亡率风险降低相关（HR，0.85；95% CI，0.75-0.96） 。在患有激素受体阳性/人表皮生长因子受体 2 阴性乳腺癌的女性中，这种下降更为明显（HR，0.71；95% CI，0.57-0.88）。结论这些发现表明，诊断后使用他汀类药物与改善相关乳腺癌女性的癌症特异性生存率应该在乳腺癌患者的他汀类药物治疗随机试验中得到证实。