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Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts

Lookup NU author(s): Professor Linda Sharp



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Preclinical studies have demonstrated that propranolol inhibits several pathways involved in breast cancer progression and metastasis. We investigated whether breast cancer patients who used propranolol, or other non-selective beta-blockers, had reduced breast cancer-specific or all-cause mortality in eight European cohorts.Methods: Incident breast cancer patients were identified from eight cancer registries and compiled through the European Cancer Pharmacoepidemiology Network. Propranolol and non-selective beta-blocker use was ascertained for each patient. Breast cancer-specific and all-cause mortality were available for five and eight cohorts, respectively. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for cancer-specific and all-cause mortality by propranolol and non-selective beta-blocker use. HRs were pooled across cohorts using meta-analysis techniques. Dose-response analyses by number of prescriptions were also performed. Analyses were repeated investigating propranolol use before cancer diagnosis.Results: The combined study population included 55,252 and 133,251 breast cancer patients in the analysis of breast cancer-specific and all-cause mortality respectively. Overall, there was no association between propranolol use after diagnosis of breast cancer and breast cancer-specific or all-cause mortality (fully adjusted HR = 0.94, 95% CI, 0.77, 1.16 and HR = 1.09, 95% CI, 0.93, 1.28, respectively). There was little evidence of a dose-response relationship. There was also no association between propranolol use before breast cancer diagnosis and breast cancer-specific or all-cause mortality (fully adjusted HR = 1.03, 95% CI, 0.86, 1.22 and HR = 1.02, 95% CI, 0.94, 1.10, respectively). Similar null associations were observed for non-selective beta-blockers.Conclusions: In this large pooled analysis of breast cancer patients, use of propranolol or non-selective beta-blockers was not associated with improved survival.

Publication metadata

Author(s): Cardwell CR, Pottegard A, Vaes E, Garmo H, Murray LJ, Brown C, Vissers PAJ, O'Rorke M, Visvanathan K, Cronin-Fenton D, De Schutter H, Lambe M, Powe DG, van Herk-Sukel MPP, Gavin A, Friis S, Sharp L, Bennett K

Publication type: Article

Publication status: Published

Journal: Breast Cancer Research

Year: 2016

Volume: 18

Online publication date: 01/12/2016

Acceptance date: 17/11/2016

Date deposited: 01/03/2017

ISSN (print): 1465-542X

ISSN (electronic): 1465-5411

Publisher: BioMed Central Ltd.


DOI: 10.1186/s13058-016-0782-5


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Funder referenceFunder name
United Kingdom National Institute for Health Research Career Development Fellowship - Health and Social Care Research and Development Division (Public Health Agency, Northern Ireland)
C19630/A13265Cancer Research-UK
HRA_HSR/2012/30Health Research Board in Ireland