β-blockers and breast cancer survival by molecular subtypes: a population-based cohort study and meta-analysis

Background The association between use of β-blockers and breast cancer (BC) prognosis has been investigated in several observational studies, with conflicting results. We performed a nationwide cohort study and a meta-analysis to investigate the association, and assess if it varied between molecular...

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Bibliographic Details
Published in:British journal of cancer 2022-10, Vol.127 (6), p.1086-1096
Main Authors: Løfling, L. Lukas, Støer, Nathalie C., Sloan, Erica K., Chang, Aeson, Gandini, Sara, Ursin, Giske, Botteri, Edoardo
Format: Article
Language:English
Subjects:
692/4028/67/1347
692/4028/67/2324
Biomedical and Life Sciences
Biomedicine
Breast cancer
Cancer Research
Cohort analysis
Drug Resistance
Epidemiology
Medical prognosis
Meta-analysis
Molecular Medicine
Observational studies
Oncology
Population studies
Population-based studies
Regression analysis
Survival
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Summary:Background The association between use of β-blockers and breast cancer (BC) prognosis has been investigated in several observational studies, with conflicting results. We performed a nationwide cohort study and a meta-analysis to investigate the association, and assess if it varied between molecular subtypes of BC. Methods We identified women aged ≥50 years with BC diagnosed between 2004 and 2018 in Norway. We used Cox regression models to estimate the association between β-blocker use at diagnosis and BC-specific survival, overall and by molecular subtype. We performed a meta-analysis of observational studies that reported molecular subtype-specific estimates of this association. Results We included 30,060 women, of which 4461 (15%) used β-blockers. After a median follow-up of 5.1 years, 2826 (9%) died of BC. Overall, β-blocker use was not associated with BC-specific survival (hazard ratio [HR] = 1.07; 95% confidence interval [CI]: 0.97–1.19). We found an association only in triple-negative BC (TNBC) patients (HR = 0.66; 95% CI: 0.47–0.91). This was confirmed in the meta-analysis: β-blocker use was associated with progression/recurrence-free (HR = 0.58; 95% CI: 0.38–0.89) and BC-specific survival (HR = 0.74; 95% CI: 0.55–1.00) in TNBC patients only. Conclusion In our cohort of BC patients and in the meta-analysis, β-blocker use was associated with prolonged BC-specific survival only in TNBC patients.
ISSN:0007-0920
1532-1827
DOI:10.1038/s41416-022-01891-7