TY - JOUR
T1 - Beta blockers and breast cancer mortality
T2 - A population-based study
AU - Barron, Thomas I.
AU - Connolly, Roisin M.
AU - Sharp, Linda
AU - Bennett, Kathleen
AU - Visvanathan, Kala
PY - 2011/7/1
Y1 - 2011/7/1
N2 - Purpose: Preclinical studies have demonstrated that antagonism of β2-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 (β1/β2 antagonist; n = 70) or atenolol (β1 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 β2- adrenergic signaling pathway can reduce breast cancer progression and mortality.
AB - Purpose: Preclinical studies have demonstrated that antagonism of β2-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 (β1/β2 antagonist; n = 70) or atenolol (β1 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 β2- adrenergic signaling pathway can reduce breast cancer progression and mortality.
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U2 - 10.1200/JCO.2010.33.5422
DO - 10.1200/JCO.2010.33.5422
M3 - Article
C2 - 21632503
AN - SCOPUS:79960138447
SN - 0732-183X
VL - 29
SP - 2635
EP - 2644
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 19
ER -