Reduced risk of breast cancer recurrence in patients using ACE inhibitors, ARBs, and/or statins

Young Kwang Chae*, Matias E. Valsecchi, Jongoh Kim, Anabella Lucca Bianchi, Danai Khemasuwan, Ajit Desai, William Tester

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

149 Scopus citations


Background: Epidemiologic and biochemical evidence suggest a role of statins and angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) as anti-neoplastic agents. This study was designed to evaluate the association between the use of these agents and the risk of breast cancer recurrence. Methods: We reviewed the medical records of patients treated for stage II/III breast cancer between 1999 and 2005. Statin and ACE-inhibitors/ARB users were defined as patients who took these medications for at least 6 months in no evidence of disease (NED) stage after the initial diagnosis. The primary outcome was disease-free survival and the secondary was overall survival. The KaplanMeier and Cox proportional hazard models were used. Results: A total of 703 patients were included. The median and maximal of follow up was 55 and 118 months, respectively. A total of 168 patients used ACE-inhibitors/ARBs, 156 patients used statins, and 81 used both. Univariate analysis showed significant reduction in breast cancer recurrence among patients who used ACE-inhibitors/ARBs (hazard ratio (HR) = 0.57; 95% CI: 0.37-0.89; p = .013) or statins (HR = 0.43; 95% CI: 0.26-0.70; p < .001). After adjusting for multiple variables, the use of ACE-inhibitors/ARBs (HR = 0.49; 95% CI: 0.31-0.76; p = .002) and statins (HR = 0.40; 95% CI: 0.24-0.67; p < .001) remained significant and an additive effect was found on those who used both drugs (HR = 0.30 95% CI: 0.15-0.61; p = .001). No association was found regarding overall survival. Conclusions: The use of ACE-inhibitors/ARBs, statins, and the combination of both were all associated with a reduced risk of breast cancer recurrence. This observation should prompt further exploration.

Original languageEnglish (US)
Pages (from-to)585-593
Number of pages9
JournalCancer Investigation
Issue number9
StatePublished - Nov 2011


  • ACE inhibitors
  • Breast cancer
  • Cancer prevention
  • Statins

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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