Beta Blockers and Breast Cancer Mortality: A Population-Based Study
By: Barron TI, Connolly RM, Sharp L, Bennett K, Visvanathan K.

Trinity College, University of Dublin, Dublin; National Cancer Registry Ireland, Cork, Ireland; and Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Centre; Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
J Clin Oncol. 2011 May 31.

Abstract

Purpose

Preclinical studies have demonstrated that antagonism of β(2)-adrenergic signaling inhibits several pathways necessary for breast tumor progression and metastasis. A series of population-based observational studies were conducted to examine associations between beta blocker use and breast tumor characteristics at diagnosis or breast cancer-specific mortality.

Patients And Methods

Linked national cancer registry and prescription dispensing data were used to identify women with a diagnosis of stage I to IV invasive breast cancer between January 1, 2001, and December 31, 2006. Women taking propranolol (β(1)/β(2) antagonist; n = 70) or atenolol (β(1) antagonist; n = 525), in the year before breast cancer diagnosis were matched (1:2) to women not taking a beta blocker (n = 4,738). Associations between use of propranolol or atenolol and risk of local tumor invasion at diagnosis (T4 tumor), nodal or metastatic involvement at diagnosis (N2/N3/M1 tumor), and time to breast cancer-specific mortality were assessed.

Results

Propranolol users were significantly less likely to present with a T4 (odds ratio [OR], 0.24, 95% CI, 0.07 to 0.85) or N2/N3/M1 (OR, 0.20; 95% CI, 0.04 to 0.88) tumor compared with matched nonusers. The cumulative probability of breast cancer-specific mortality was significantly lower for propranolol users compared with matched nonusers (hazard ratio, 0.19; 95% CI, 0.06 to 0.60). There was no difference in T4 or N2/N3/M1 tumor incidence or breast cancer-specific mortality between atenolol users and matched nonusers.

Conclusion

The results provide evidence in humans to support preclinical observations suggesting that inhibiting the β(2)-adrenergic signaling pathway can reduce breast cancer progression and mortality.

PMID: 21632503 [PubMed - as supplied by publisher] Source: National Library of Medicine.







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