Examining the influence of beta blockers and ACE inhibitors on the risk for breast cancer recurrence: results from the LACE cohort.

TitleExamining the influence of beta blockers and ACE inhibitors on the risk for breast cancer recurrence: results from the LACE cohort.
Publication TypeJournal Article
Year of Publication2011
AuthorsGanz PA, Habel LA, Weltzien EK, Caan BJ, Cole SW
JournalBreast Cancer Res Treat
Volume129
Issue2
Pagination549-56
Date Published2011 Sep
ISSN1573-7217
KeywordsAdrenergic beta-Antagonists, Adult, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Breast Neoplasms, California, Chi-Square Distribution, Female, Humans, Middle Aged, Neoplasm Recurrence, Local, Proportional Hazards Models, Registries, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome
Abstract

There is increasing interest in the relationship between host lifestyle factors and the outcomes of cancer treatment. Behavioral factors, comorbid conditions, and non-cancer-related pharmaceutical exposures may affect breast cancer (BC) outcomes. We used observational data from the LACE Study cohort (women with early stage BC from the Kaiser Permanente Northern California Cancer Registry) to examine the association between beta blockers (BBs) and/or angiotensin-converting enzyme inhibitors (ACEi) and BC recurrence, BC-specific mortality, and overall mortality. Among 1,779 women, there were 292 BC recurrences, 174 BC deaths, and 323 total deaths. 23% were exposed to either a BB and/or an ACEi. These drugs were associated with older age, postmenopausal status, tamoxifen therapy, greater pre-diagnosis BMI, hypertension, and diabetes. In Cox proportional hazards models, ACEi exposure was associated with BC recurrence (HR 1.56, 95% CI 1.02, 2.39, P = 0.04), but not cause-specific or overall mortality. Combined ACEi and BB were associated with overall mortality (HR 1.94, 95% CI 1.22, 3.10, P = 0.01). BB exposure was associated with lower hazard of recurrence and cause-specific mortality. However, there was no evidence of a dose response with either medication. For recurrence and cause-specific mortality, BB combined with ACEi was associated with a lower HR for the outcome than when ACEi alone was used. These hypothesis generating findings suggest that BC recurrence and survival were associated with exposure to two commonly used classes of anti-hypertensive medications. These observations need to be confirmed and suggest that greater attention should focus on the potential role of these commonly used medications in BC outcomes.

DOI10.1007/s10549-011-1505-3
Alternate JournalBreast Cancer Res. Treat.
PubMed ID21479924
PubMed Central IDPMC3145014
Grant ListR01 CA098838 / CA / NCI NIH HHS / United States
R01 CA098838-07 / CA / NCI NIH HHS / United States
R01 CA109650 / CA / NCI NIH HHS / United States
R01 CA109650 / CA / NCI NIH HHS / United States
R01 CA109650-05 / CA / NCI NIH HHS / United States
R01 CA116778 / CA / NCI NIH HHS / United States
R01 CA116778 / CA / NCI NIH HHS / United States
R01 CA116778-05 / CA / NCI NIH HHS / United States
R01 CA129059 / CA / NCI NIH HHS / United States
R01 CA129059 / CA / NCI NIH HHS / United States
R01 CA129059-03 / CA / NCI NIH HHS / United States
R01 CA98838 / CA / NCI NIH HHS / United States