Lipophilic stains alter biology of emergent breast cancer
MedWire News: Women who use lipophilic statins in the year leading up to a diagnosis of breast cancer are 37% less likely to develop the hormone unresponsive form of the disease than women who have never used statins, say US researchers.
Lipophilic statin users were also 44% more likely to be diagnosed with a grade 1 tumor and 42% more likely to be diagnosed with locally confined breast cancer than non-users.
Given that hormone receptor negative breast cancer is a more aggressive and less treatable form of the disease than hormone receptor positive cancer, the researchers say clinicians "can ill afford to ignore" the possibility that statins improve prognosis.
"The rapidly growing number of epidemiologic studies addressing statins and cancer... have generally concluded that there is no convincing clinical evidence supporting either a cancer-promoting or cancer-preventing effect for statins," Laura Esserman (University of California-San Francisco) and colleagues observe.
However, these studies have often failed to take into account the use of lipophilic versus hydrophilic statins and the fact that breast cancer is a heterogeneous disease with biologically distinct subtypes, the researchers add in the journal Cancer Epidemiology, Biomarkers and Prevention.
Esserman and colleagues therefore conducted a retrospective cohort analysis of all cases of primary ductal carcinoma in situ and invasive breast cancer diagnosed within the Kaiser Permanente Northern California healthcare system in 2003.
Of the 2141 women diagnosed with breast cancer, 387 used lipophilic statins and 17% had documented sustained use in the year prior to breast cancer diagnosis.
This latter group of women showed a significant reduction in estrogen receptor (ER)/ progesterone receptor (PR)-negative tumors and were more frequently diagnosed with grade 1 tumors that were locally confined to the breast compared with those who had never used lipophilic statins.
Patients of Asian, Hispanic, or African-American ethnicity were more likely to be diagnosed with ER/PR-negative tumors and less likely to use lipophilic statins than their Caucasian counterparts. However, those minority women who did use the drugs showed a relative reduction in ER/PR-negative tumors, although the sample size was too small to be significant.
In an accompanying editorial, Tim Byers of the University of Colorado in Denver said that altering the phenotype of emergent breast cancers could be a powerful tool, adding that investigators should also look at the effect of lipophilic statins on the triple-negative breast cancer subtype.
Cancer Epidemiol Biomarkers Prev 2008; Advance online publication
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