Beta-blockers and breast cancer survival by molecular subtypes: a population-based cohort study and meta-analysis
A partir d'une revue de la littérature et de données portant sur des patientes atteintes d'un cancer du sein diagnostiqué entre 2004 et 2018 en Norvège (30 060 patientes au total ; durée médiane de suivi : 5,1 ans), cette méta-analyse évalue l'association entre une utilisation de béta-bloquants (4 461 utilisatrices) et la survie spécifique selon le sous-type moléculaire
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.