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Cholesterol-Lowering Medication Use and Breast Cancer Outcome in the BIG 1-98 Trial

A report by Borgquist et al in the Journal of Clinical Oncology indicates that the use of cholesterol-lowering medication during adjuvant endocrine therapy in the BIG 1-98 trial was associated with a reduced risk of disease recurrence in women with hormone receptor–positive breast cancer.

The BIG 1-98 trial, conducted from 1998 to 2003, evaluated several adjuvant endocrine protocols (tamoxifen vs aromatase inhibitor) in more than 8,000 postmenopausal women with early-stage, hormone receptor–positive invasive breast cancer.

Serum cholesterol levels decreased during tamoxifen treatment and returned to pretamoxifen levels after tamoxifen treatment ended, irrespective of whether tamoxifen was given alone, prior to, or after the aromatase inhibitor letrozole. In contrast, cholesterol levels were unchanged from baseline levels during letrozole treatment, whether given alone, prior to, or after tamoxifen. In multivariate analysis, compared with no use of cholesterol-lowering medication, initiation of cholesterol-lowering medication was associated with significantly better disease-free survival, breast cancer–free interval, and distant recurrence–free interval, with no significant interaction between the effects of cholesterol-lowering medication and the assigned endocrine treatment.

The authors concluded that cholesterol-lowering medication during adjuvant endocrine therapy may have a role in preventing breast cancer recurrence in hormone receptor–positive early-stage breast cancer.


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