Beta Blockers and Breast Cancer Mortality: A Population-Based Study
Beta Blockers and Breast Cancer Mortality: A Population-Based Study
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DOI：
10.1200/jco.2010.33.5422
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发表时间：
2011-07-01
影响因子：
45.3
通讯作者：
Visvanathan, Kala
中科院分区：
文献类型：
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作者：
Barron, Thomas I.;Connolly, Roisin M.;Visvanathan, Kala
目的临床前研究表明，阻断β 2肾上腺素能信号通路可抑制乳腺肿瘤进展和转移所必需的几条通路。一系列以人群为基础的观察性研究进行了检查β受体阻滞剂的使用和乳腺肿瘤的特征之间的关联在诊断或乳腺癌特异性mortality.Patients and MethodsLinked国家癌症登记处和处方配药数据被用来确定妇女与诊断阶段I至IV浸润性乳腺癌之间的2001年1月1日，2006年12月31日。在乳腺癌诊断前一年服用普萘洛尔（β（1）/β（2）拮抗剂; n = 70）或阿替洛尔（β（1）拮抗剂; n = 525）的女性与未服用β受体阻滞剂的女性（n = 4，738）匹配（1：2）。普萘洛尔或阿替洛尔的使用与诊断时局部肿瘤浸润风险的关系（T4肿瘤），诊断时累及淋巴结或转移（N2/N3/M1肿瘤）和时间乳腺癌特异性死亡率进行了评估。（比值比[OR]，0.24，95% CI，0.07至0.85）或N2/N3/M1（OR，0.20; 95% CI，0.04至0.88）肿瘤。普萘洛尔使用者乳腺癌特异性死亡率的累积概率显著低于匹配的非使用者（风险比，0.19; 95%CI，0.06 - 0.60）。阿替洛尔使用者和匹配的nonusers.ConclusionThe结果在人类提供的证据支持临床前观察表明，抑制β（2）-肾上腺素能信号通路可以减少乳腺癌的进展和死亡率之间的T4或N2/N3/M1肿瘤的发病率或乳腺癌特异性死亡率没有差异。J Clin Oncol 29：2635-2644. (C)2011年美国临床肿瘤学会
PurposePreclinical studies have demonstrated that antagonism of beta(2)-adrenergic signaling inhibits several pathways necessary for breast tumor progression and metastasis. A series of population-based observational studies were conducted to examine associations between beta blocker use and breast tumor characteristics at diagnosis or breast cancer-specific mortality.Patients and MethodsLinked national cancer registry and prescription dispensing data were used to identify women with a diagnosis of stage I to IV invasive breast cancer between January 1, 2001, and December 31, 2006. Women taking propranolol (beta(1)/beta(2) antagonist; n = 70) or atenolol (beta(1) antagonist; n = 525), in the year before breast cancer diagnosis were matched (1:2) to women not taking a beta blocker (n = 4,738). Associations between use of propranolol or atenolol and risk of local tumor invasion at diagnosis (T4 tumor), nodal or metastatic involvement at diagnosis (N2/N3/M1 tumor), and time to breast cancer-specific mortality were assessed.ResultsPropranolol users were significantly less likely to present with a T4 (odds ratio [OR], 0.24, 95% CI, 0.07 to 0.85) or N2/N3/M1 (OR, 0.20; 95% CI, 0.04 to 0.88) tumor compared with matched nonusers. The cumulative probability of breast cancer-specific mortality was significantly lower for propranolol users compared with matched nonusers (hazard ratio, 0.19; 95% CI, 0.06 to 0.60). There was no difference in T4 or N2/N3/M1 tumor incidence or breast cancer-specific mortality between atenolol users and matched nonusers.ConclusionThe results provide evidence in humans to support preclinical observations suggesting that inhibiting the beta(2)-adrenergic signaling pathway can reduce breast cancer progression and mortality. J Clin Oncol 29: 2635-2644. (C) 2011 by American Society of Clinical Oncology