Abstract | PURPOSE: MATERIALS AND METHODS: We studied 7,452 patients who had undergone surgery for breast cancer at Seoul National University Hospital from 2008 to 2015 using the nationwide claims database. Exposure was defined as a recorded prescription of each drug within 12 months before the diagnosis of breast cancer. RESULTS: Patients with prior insulin or statin use were more likely to be older than 50 years at diagnosis and had a higher comorbidity index than those without it (p < 0.01 for both). The hazard ratio (HR) for death with insulin use was 5.7 (p < 0.01), and the effect was attenuated with both insulin and metformin exposure with an HR of 1.2 (p=0.60). In the subgroup analyses, a heightened risk of death with insulin was further prominent with an HR of 17.9 (p < 0.01) and was offset by co-administration of metformin with an HR of 1.3 (p=0.67) in patients with estrogen receptor (ER)-negative breast cancer. Statin use was associated with increased overall mortality only in patients with ER-positive breast cancer with HR for death of 1.5 (p=0.05). CONCLUSION:
Insulin or statin use before the diagnosis of breast cancer was associated with an increase in all-cause mortality. Subsequent analyses suggested that metformin or statin use may have been protective in patients with ER-negative disease, which warrants further studies.
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Authors | Mihong Choi, Jiyeon Han, Bo Ram Yang, Myoung-Jin Jang, Miso Kim, Dae-Won Lee, Tae-Yong Kim, Seock-Ah Im, Han-Byoel Lee, Hyeong-Gon Moon, Wonshik Han, Dong-Young Noh, Kyung-Hun Lee |
Journal | Cancer research and treatment
(Cancer Res Treat)
Vol. 53
Issue 1
Pg. 65-76
(Jan 2021)
ISSN: 2005-9256 [Electronic] Korea (South) |
PMID | 32972040
(Publication Type: Journal Article)
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Chemical References |
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Insulin
- Metformin
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Topics |
- Breast Neoplasms
(drug therapy, mortality, pathology)
- Female
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
(pharmacology, therapeutic use)
- Insulin
(pharmacology, therapeutic use)
- Male
- Metformin
(pharmacology, therapeutic use)
- Survival Analysis
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