Breast cancer: beta-blockers are not linked to better outcomes: meta-analysis

  • Li C & al.
  • Biosci Rep
  • 21 May 2020

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A large meta-analysis finds no association between beta-blocker use and better clinical outcomes in breast cancer.

Why this matters

  • Prior studies have suggested that beta-adrenoreceptor activation is involved in the pathogenesis and progression of many cancers.
  • The inference from this evidence was that beta-blockers might be beneficial for breast cancer.
  • However, this meta-analysis finds no benefit of beta-blocker use in breast cancer prognosis.

Study design

  • Meta-analysis of 17 observational studies with 75,074 patients after search of PubMed, EMBASE, and Cochrane Library.
  • Funding: None.

Key results

  • No association (risk ratios) was found between beta-blocker use and:
    • Breast cancer recurrence: 0.85 (P=.17).
    • Breast-cancer-related mortality: 0.83 (P=.14). 
    • All-cause mortality: 1.01 (P=.91).
  • Results were not affected by sample size, definition of beta-blocker use, follow-up duration, adjustment of menopausal status, or quality score.
  • Subgroup analysis found that beta-blocker use did significantly reduce the risk ratio for breast cancer-related deaths by 19% in prospective studies (0.81; P=.05), but not in retrospective studies (1.06; P=.16).

Limitations

  • Half of studies were retrospective.
  • All were observational.
  • High heterogeneity across studies.