The relationship between statins and breast cancer prognosis varies by statin type and exposure time: A meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21606-e21606
Author(s):  
Binliang Liu ◽  
Zongbi Yi ◽  
Xiuwen Guan ◽  
Fei Ma ◽  
Yi-Xin Zeng
Keyword(s):  
Breast Cancer ◽  
Protective Effect ◽  
Breast Cancer Prognosis ◽  
Cancer Prognosis ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Relationship ◽  
Statin Use

e21606 Background:Breast cancer is the most common cancer in females. The effects of statins on breast cancer prognosis have long been controversial, so it is important to investigate the relationship between statin type, exposure time, and breast cancer prognosis. This study sought to explore the effect of statins on breast cancer prognosis. Methods:We searched the MEDLINE, EMBASE, Cochrane Library between October 15, 2016 and January 20, 2017. Searches combined the terms “breast neoplasms[MeSH]”, “statins”, “prognosis” or “survival” or “mortality” with no limit on publication date. Data were analyzed using Stata/SE 11.0. Results: 7 studies finally met the selection criteria and 197,048 included women. Overall statin use was associated with lower cancer-specific mortality and all-cause mortality (HR 0.73, 95% CI 0.59-0.92, P = 0.000 and HR 0.72, 95% CI 0.58-0.89, P = 0.000). Lipophilic statins were associated with decreased breast cancer-specific and all-cause mortality (HR 0.57, 95% CI 0.46-0.70, P = 0.000 and HR 0.57, 95% CI 0.48-0.69, P = 0.000); however, hydrophilic statins were weakly protective against only all-cause mortality (HR 0.79, 95% CI 0.65-0.97, P = 0.132) and not breast cancer-specific mortality (HR 0.94, 95% CI 0.76-1.17, P = 0.174). Of note, more than four years of follow-up did not show a significant correlation between statin use and cancer-specific mortality or all-cause mortality (HR 0.84, 95% CI 0.71-1.00, P = 0.616 and HR 0.95, 95% CI 0.75-1.19, P = 0.181), while groups with less than four years of follow-up still showed the protective effect of statins against cancer-specific mortality and all-cause mortality (HR 0.62, 95% CI 0.44-0.87, P = 0.000 and HR 0.61, 95% CI 0.45-0.80, P = 0.000). Conclusions:Although statins can reduce breast cancer patient mortality, the benefit appears to be constrained by statin type and follow-up time. Lipophilic statins showed a strong protective function in breast cancer patients, while hydrophilic statins only slightly improved all-cause mortality. Finally, the protective effect of statins could only be observed in groups with less than four years of follow-up.

scholarly journals Association of circulating leptin, adiponectin, and resistin concentrations with long-term breast cancer prognosis in a German patient cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nadia Obi ◽  
Audrey Y. Jung ◽  
Tabea Maurer ◽  
Marianne Huebner ◽  
Theron Johnson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Population Based ◽  
Cancer Prognosis ◽  
Low Grade ◽  
Breast Cancer Patients ◽  
Breast Cancer Specific Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

AbstractAdipokines including leptin, adiponectin and resistin have been linked to risk of obesity-related cancers potentially through low-grade chronic inflammation pathways. We aimed to assess the role of post-diagnosis circulating adipokines on long-term prognosis in a prospective breast cancer cohort. Adipokines were measured in blood collected at baseline shortly after diagnosis (2002–2005) and at follow-up (2009) from 3112 breast cancer patients enrolled in the population-based MARIE study. Half of the patients had measurements at both time-points. All-cause mortality, breast cancer specific mortality and recurrences were ascertained up to June 2015 (11 years median follow-up). Associations with time-varying adipokine concentrations overall and stratified by estrogen and progesterone receptor (ERPR) were evaluated using adjusted proportional hazard regression. At baseline (n = 2700) and follow-up (n = 2027), median concentrations for leptin, adiponectin and resistin were 4.6 and 2.7 ng/ml, 24.4 and 30.0 mg/l, 15.4 and 26.2 ng/ml, respectively. After adjustment, there was no evidence for associations between adipokines and any outcome overall. In ERPR negative tumors, highest vs. lowest quintile of adiponectin was significantly associated with increased breast cancer specific mortality (HR 2.51, 95%CI 1.07–5.92). Overall, post-diagnosis adipokines were not associated with long-term outcomes after breast cancer. In patients with ERPR negative tumors, higher concentrations of adiponectin may be associated with increased breast cancer specific mortality and warrant further investigation.

scholarly journals Multidimensional Machine Learning Personalized Prognostic Model in an Early Invasive Breast Cancer Population-Based Cohort in China: Algorithm Validation Study (Preprint)

2020 ◽  
Author(s):  
Xiaorong Zhong ◽  
Ting Luo ◽  
Ling Deng ◽  
Pei Liu ◽  
Kejia Hu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Invasive Breast Cancer ◽  
Prognostic Model ◽  
The United States ◽  
Biomedical Ethics ◽  
Extreme Gradient Boosting ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

BACKGROUND Current online prognostic prediction models for breast cancer, such as Adjuvant! Online and PREDICT, are based on specific populations. They have been well validated and widely used in the United States and Western Europe; however, several validation attempts in non-European countries have revealed suboptimal predictions. OBJECTIVE We aimed to develop an advanced breast cancer prognosis model for disease progression, cancer-specific mortality, and all-cause mortality by integrating tumor, demographic, and treatment characteristics from a large breast cancer cohort in China. METHODS This study was approved by the Clinical Test and Biomedical Ethics Committee of West China Hospital, Sichuan University on May 17, 2012. Data collection for this project was started in May 2017 and ended in March 2019. Data on 5293 women diagnosed with stage I to III invasive breast cancer between 2000 and 2013 were collected. Disease progression, cancer-specific mortality, all-cause mortality, and the likelihood of disease progression or death within a 5-year period were predicted. Extreme gradient boosting was used to develop the prediction model. Model performance was assessed by calculating the area under the receiver operating characteristic curve (AUROC), and the model was calibrated and compared with PREDICT. RESULTS The training, test, and validation sets comprised 3276 (499 progressions, 202 breast cancer-specific deaths, and 261 all-cause deaths within 5-year follow-up), 1405 (211 progressions, 94 breast cancer-specific deaths, and 129 all-cause deaths), and 612 (109 progressions, 33 breast cancer-specific deaths, and 37 all-cause deaths) women, respectively. The AUROC values for disease progression, cancer-specific mortality, and all-cause mortality were 0.76, 0.88, and 0.82 for training set; 0.79, 0.80, and 0.83 for the test set; and 0.79, 0.84, and 0.88 for the validation set, respectively. Calibration analysis demonstrated good agreement between predicted and observed events within 5 years. Comparable AUROC and calibration results were confirmed in different age, residence status, and receptor status subgroups. Compared with PREDICT, our model showed similar AUROC and improved calibration values. CONCLUSIONS Our prognostic model exhibits high discrimination and good calibration. It may facilitate prognosis prediction and clinical decision making for patients with breast cancer in China.

scholarly journals Statin Use and Breast Cancer Prognosis in Black and White Women

2017 ◽  
Vol 9 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Amanda Leiter ◽  
Nina A. Bickell ◽  
Derek LeRoith ◽  
Anupma Nayak ◽  
Sheldon M. Feldman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
White Women ◽  
Breast Cancer Prognosis ◽  
Cancer Prognosis ◽  
Black And White ◽  
Statin Use

scholarly journals Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up)

2020 ◽  
Vol 18 (1) ◽  
pp. 84
Author(s):  
Trinidad Dierssen-Sotos ◽  
Inés Gómez-Acebo ◽  
Nuria Gutiérrez-Ruiz ◽  
Nuria Aragonés ◽  
Pilar Amiano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Protective Effect ◽  
Dietary Habits ◽  
Cox Regression ◽  
Menopausal Status ◽  
Premenopausal Women ◽  
Normal Weight ◽  
High Intake ◽  
The Relationship

The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as “high intakes” those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5–25 kg/m2) a high intake of carbohydrates (≥809 Kcal/day), specifically monosaccharides (≥468 Kcal/day), worsened prognostic compared to lowest (≤352 Kcal/day). Hazard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95% CI (1.04 to 4.72) and HR:2.59 95% CI (1.04 to 6.48), respectively (p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (≥135 Kcal/day) improved global survival (HR: 0.39 95% CI (0.15 to 1.02) p-trend = 0.05) compared to the lowest (≤92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (≥811 Kcal/day) showed a protective effect (HR:0.20 95% CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (≥238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of different nutrients.

scholarly journals Age Increased Cancer-specific Mortality Risk of Thyroid Cancer With Lung Metastasis

2021 ◽  
Author(s):  
Xiu Huang ◽  
Qing Xia ◽  
Shen Qu ◽  
Aimei Peng ◽  
Jie Yang
Keyword(s):  
Thyroid Cancer ◽  
Lung Metastasis ◽  
Distant Metastases ◽  
Individual Treatment ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Relationship

Abstract Background: To investigate the relationship between age and cancer-specific mortality in thyroid cancer (TC) with lung-metastasis.Methods: 1,418 patients with initial distant metastases from Surveillance, Epidemiology and End Results databases were investigated. Patients with median follow-up time of 8 months [interquartile range (IQR), 2–27] and median age of 66 years (IQR, 55-76) were divided into five groups by age and the association between age and TC-specific mortality was analyzed.Results: The TC-specific mortality rates were 32.78% (118/360), 46.71% (156/334), 53.93% (199/369), 58.96% (158/268) and 82.76% (72/87) for patients with age of ≤55 years,56-65 years, 66-75 years, 76-85 years and >85 years. Kaplan-Meier curves showed that TC-specific mortality rate was associated with increased age (p < 0.001). Compared with patients ≤55 years, patients of 56-65 years, 66-75 years, 76-85 years and >85 years had significantly higher hazard ratios (HRs) of 1.69(1.26-2.26), 1.97 (1.47-2.64), 2.18(1.59-2.99) and 3.24(2.08-5.06) after adjustments for gender, tumor size and radiation therapy (all p < 0.001).In TC with initial lung-metastasis, compared with patients ≤55 years, patients of 56-65 years, 66-75 years, 76-85 years and >85 years had significantly higher adjusted HRs of 1.68(1.20-2.36, p=0.003), 2.18(1.57-3.02), 2.16(1.51-3.08) and 2.91(1.79-4.75) (p < 0.001). Similar results could be obtained in papillary thyroid cancer.Conclusions: The TC-specific mortality increased with age in TC patients with initial lung-metastasis, which suggested that further risk stratification based on age was necessary for TC over 55 years with lung-metastasis. Individual treatment strategy maybe recommended for patients over 85 years.

Mortgage Lending Bias and Breast Cancer Survival Among Older Women in the United States

2021 ◽  
pp. JCO.21.00112
Author(s):  
Kirsten M. M. Beyer ◽  
Yuhong Zhou ◽  
Purushottam W. Laud ◽  
Emily L. McGinley ◽  
Tina W. F. Yen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Older Women ◽  
Cancer Survival ◽  
The United States ◽  
Mortgage Lending ◽  
Comorbid Conditions ◽  
Breast Cancer Specific Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
The Relationship

PURPOSE The objective was to examine the relationship between contemporary redlining (mortgage lending bias on the basis of property location) and survival among older women with breast cancer in the United States. METHODS A redlining index using Home Mortgage Disclosure Act data (2007-2013) was linked by census tract with a SEER-Medicare cohort of 27,516 women age 66-90 years with an initial diagnosis of stage I-IV breast cancer in 2007-2009 and follow-up through 2015. Cox proportional hazards models were used to examine the relationship between redlining and both all-cause and breast cancer–specific mortality, accounting for covariates. RESULTS Overall, 34% of non-Hispanic White, 57% of Hispanic, and 79% of non-Hispanic Black individuals lived in redlined tracts. As the redlining index increased, women experienced poorer survival. This effect was strongest for women with no comorbid conditions, who comprised 54% of the sample. For redlining index values of 1 (low), 2 (moderate), and 3 (high), as compared with 0.5 (least), hazard ratios (HRs) (and 95% CIs) for all-cause mortality were HR = 1.10 (1.06 to 1.14), HR = 1.27 (1.17 to 1.38), and HR = 1.39 (1.25 to 1.55), respectively, among women with no comorbidities. A similar pattern was found for breast cancer–specific mortality. CONCLUSION Contemporary redlining is associated with poorer breast cancer survival. The impact of this bias is emphasized by the pronounced effect even among women with health insurance (Medicare) and no comorbid conditions. The magnitude of this neighborhood level effect demands an increased focus on upstream determinants of health to support comprehensive patient care. The housing sector actively reveals structural racism and economic disinvestment and is an actionable policy target to mitigate adverse upstream health determinants for the benefit of patients with cancer.

Influence of competing risks on estimates of recurrence risk and breast cancer-specific mortality in analyses of the Early Breast Cancer Trialists Collaborative Group.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 533-533
Author(s):  
Ramy Saleh ◽  
Michelle Nadler ◽  
Alexandra Desnoyers ◽  
Danielle Lee Rodin ◽  
Husam Abdel-Qadir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Competing Risks ◽  
Relative Difference ◽  
Competing Risk ◽  
Collaborative Group ◽  
Breast Cancer Specific Mortality ◽  
Kaplan Meier ◽  
Specific Mortality ◽  
Cancer Specific Mortality

533 Background: Early stage breast cancer is a curable disease with the majority of patients dying of causes other than breast cancer. The influence of these competing risks of death on the interpretation of Kaplan-Meier(KM)-based analyses such as those performed by the Early Breast Cancer Trialists Collaborative Group (EBCTCG) are unknown. Methods: We searched the Clinical Trial Service Unit and Epidemiological Studies Unit website at Oxford University to identify all meta-analyses published by the EBCTCG between 2005 and 2018. Studies were included if they contained KM curves with risk estimates for either breast cancer mortality and/or breast cancer recurrence. The potential influence of competing risks was estimated using a validated multivariate linear model that predicts the amount that the KM risk estimates are biased relative to outcome risk measured with the cumulative incidence function (CIF). Results: The initial search identified 14 analyses published by the EBCTCG with 10 of the 14 studies (71%) susceptible to competing risk bias cited both the number of events of interest and competing events. Eight of the ten studies (80%) had a relative difference between the KM estimate and the competing risk adjusted estimate of more than 10% while 2 of 10 (20%) had a difference of less than 10%. The relative difference between the KM and adjusted estimates was 28.4% for local recurrence, 16.8% for distant recurrence, and 6.7% for breast cancer-specific mortality. There was 2.2% difference between KM and adjusted analyses between 0-4 years and 18.9% beyond 10 years of follow up. Use of KM and CIF-based analysis did not influence treatment effect in the majority of included studies. Conclusions: This study provides estimates for the overestimation of risk in Kaplan-Meier analyses resulting from failure to address competing risk bias. CIFs are more appropriate to measure outcome risk over time and should be used especially for long-term follow-up studies and for analysis of rare events.

scholarly journals The 2018 WCRF/AICR Score and All-Cause and Cancer-Specific Mortality Risk: A Longitudinal Analysis in the NIH-AARP Diet and Health Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1486-1486
Author(s):  
Marissa Shams-White ◽  
Nigel Brockton ◽  
Giota Mitrou ◽  
Lisa Kahle ◽  
Jill Reedy
Keyword(s):  
Older Adults ◽  
Cancer Research ◽  
Health Study ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Former Smokers ◽  
Never Smokers ◽  
Reduced Risk

Abstract Objectives To examine how adherence to the 2018 World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) Cancer Prevention Recommendations may impact risk for all-cause and cancer-specific mortality among older adults in the NIH-AARP Diet and Health Study. Methods The seven components of the 2018 WCRF/AICR Score were calculated using baseline data (1995–1997) for dietary intake (124-item food frequency questionnaire), height, weight, and waist circumference, and a follow-up questionnaire (2004) for moderate and vigorous physical activity (N = 220,389). Total Scores were categorized (0–2 (ref), &gt; 2–5, and 5–7 points). Covariates included age, race/ethnicity, marital status, education, total energy, and diabetes, and hormone replacement therapy (women only). Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated, stratified by sex and smoking status (never, former, current). Results There were 24,119 and 8170 all-cause and cancer deaths, respectively, through 2011 during a mean 14.7 person-years of follow-up. Men with the highest (5–7 points) compared to the lowest 2018 WCRF/AICR Scores had a reduced risk of all-cause mortality depending on smoking history: never HR: 0.46 (95% CI 0.38–0.55); former HR: 0.42 (95% CI 0.36–0.48); current HR: 0.56 (95% CI 0.39–0.80). Findings were similar among women (never HR: 0.45 (95% CI 0.38–0.53); former HR: 0.41 (95% CI 0.35–0.49); current HR: 0.48 (95% CI 0.38–0.61)). For cancer mortality, there was a reduced risk for former smokers (men HR: 0.52 (95% CI 0.42– 0.66); women HR: 0.67 (95% CI 0.51– 0.89)) and never smokers (women only, HR: 0.55 (95% CI 0.40–0.75)), but this was not seen for current smokers or men who reported never smoking. Conclusions We found greater adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations to be associated with a lower risk for all-cause mortality in older adults, as well as cancer-specific mortality among former smokers and female never smokers. Future research is warranted to further explore how smoking modifies these relationships, and the influence of the different constructs included in the Score in different populations and in different cancer-relevant outcomes. Funding Sources All authors contributed their efforts without receiving funding or salary support.

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