High Cholesterol Linked to Reduced Rates of Breast Cancer, Improved Mortality

Women with high cholesterol are less likely to develop breast cancer compared with women who have lower cholesterol levels, according to a new study. The findings suggest a link between statin use and lower rates of breast cancer and mortality.

For the study, investigators followed women 40 years or older with, and without, a diagnosis of high cholesterol. They compared the development of breast cancer and subsequent mortality rates between the 2 groups.

Patients who were admitted to hospitals in the UK with high cholesterol between January 1, 2000, and March 31, 2013, were recruited from the Algorithm for Comorbidities, Associations, Lengths of stay and Mortality (ACALM) clinical database.

The investigators compared 16,043 women aged 40 or older with high cholesterol to matched equivalents without high cholesterol.

The results of the study showed patients with high cholesterol were 45% less likely to develop breast cancer than those without.

“Our research confirms that women with a diagnosis of high cholesterol have strikingly lower rates of breast cancer with improved death rates and survival,” said lead author Paul Carter. “Building on previous research by us and other groups, including animal studies in which statins reduced the risk of breast cancer, this gives a strong indication that statins produce this protective effect in breast cancer. Statins have some of the best mortality evidence amongst all cardiovascular medications and their use in patients with a diagnosis of high cholesterol is likely the reason this diagnosis appears to be protective against the development of breast cancer and subsequent mortality.”

After adjusting for factors that include age, sex, ethnicity, and the 10 most common causes of death in the UK, the findings revealed patients who developed breast cancer were 40% less likely to die if they had high cholesterol than if they did not have it.

“Compared to those without high cholesterol, patients with high cholesterol had a 45% reduced risk of breast cancer, and if they did develop breast cancer, a 40% reduced chance of death,” said senior author Dr Rahul Potluri, who founded the ALCALM study unit at Aston Medical School, Birmingham, UK. “If a diagnosis of high cholesterol leads to lower breast cancer rates this must either relate to something inherent in the condition or affected patients, or more likely to treatment with widely used cholesterol lowering interventions such as statins.

“This is the most conclusive and direct evidence as yet to confirm the link between high cholesterol and breast cancer, a topic that has been fascinating researchers for the past few years.”

Based on prior findings by the investigators that show an association between high cholesterol and the development of breast cancer, they designed the current study to follow-up with patients longitudinally and to address the relationship more in-depth.

“Showing that patients with high cholesterol have a lower risk of developing breast cancer and subsequent mortality in a longitudinal study like this provides the strongest evidence for a protective effect, which is likely related to statins,” Potluri said.

The findings, presented at European Society of Cardiology Congress, suggest that statins are associated with lower rates of breast cancer and subsequent mortality, according to the authors.

“The results of this study provide the justification to date for a clinical trial evaluating the protective effect of statins in patients with breast cancer, and this is what we intend to do,” Carter said. “Patients with breast cancer who have high cholesterol, people at high risk of cardiovascular disease, and those with established cardiovascular disease should be given statins according to current guidelines. I don’t think at the moment we can give statins to prevent or reduce mortality from breast cancer per se. But a positive result in a clinical trial could change this and it is an exciting and rapidly progressing field.”