Breast cancer is the most frequently diagnosed cancer in women and it is the second most common cause of cancer mortality. Breast cancer incidence rates have continued to rise since 1980, while mortality rates have declined. As a result, more women are at risk for breast cancer recurrences. Recurrences have important negative consequences requiring a variety of palliative treatments and often lead to death. Numerous commonly used medications such as such as, statins, antihypertensives, antidepressants, and antibiotics have been hypothesized to alter breast cancer risk, in many cases, there is strong biologic evidence to support these hypotheses. However, no studies have examined how these commonly used medications are associated with risk of breast cancer recurrence. We propose to test the hypotheses that use of statins and ACE inhibitors will be associated with a reduced risk of recurrence, and use of antidepressants, antibiotics, calcium channel blockers, and diuretics will be associated with an increased risk of recurrence. To test these hypotheses, we will conduct a retrospective cohort study among approximately 4,550 women diagnosed between 1990 and 2008 with incident early stage invasive breast carcinoma, while enrolled at Group Health Cooperative, a large Health Maintenance Organization in western Washington State. We will use medical records and automated administrative data to follow women an average of 10 years to assess risk of breast cancer recurrence and to collect information on medication use and indication for use, primary therapy, and co-morbidities. Determining whether use of these drugs impacts breast cancer recurrence is of considerable public health importance given the widespread and increasing use of the medications under study and the burden of breast cancer in our nation. The hypotheses we are seeking to test are in line with the National Cancer Institute's 2015 goals of eliminating the suffering and death due to cancer. Learning more about whether there are factors that influence recurrence will help us with the secondary prevention of breast cancer and will lead to a reduction in breast cancer morbidity and mortality.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Epidemiology of Cancer Study Section (EPIC)
Program Officer
Simonds, Naoko
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Group Health Cooperative
United States
Zip Code
Wirtz, Heidi S; Calip, Gregory S; Buist, Diana S M et al. (2017) Evidence for Detection Bias by Medication Use in a Cohort Study of Breast Cancer Survivors. Am J Epidemiol 185:661-672
Chubak, Jessica; Bowles, Erin J A; Yu, Onchee et al. (2016) Breast cancer recurrence in relation to antidepressant use. Cancer Causes Control 27:125-36
Calip, Gregory S; Hubbard, Rebecca A; Stergachis, Andy et al. (2015) Adherence to oral diabetes medications and glycemic control during and following breast cancer treatment. Pharmacoepidemiol Drug Saf 24:75-85
Chubak, Jessica; Onega, Tracy; Zhu, Weiwei et al. (2015) An Electronic Health Record-based Algorithm to Ascertain the Date of Second Breast Cancer Events. Med Care :
Calip, Gregory S; Yu, Onchee; Hoskins, Kent F et al. (2015) Associations between diabetes medication use and risk of second breast cancer events and mortality. Cancer Causes Control 26:1065-77
Carrell, David S; Halgrim, Scott; Tran, Diem-Thy et al. (2014) Using natural language processing to improve efficiency of manual chart abstraction in research: the case of breast cancer recurrence. Am J Epidemiol 179:749-58
Calip, Gregory S; Malone, Kathleen E; Gralow, Julie R et al. (2014) Metabolic syndrome and outcomes following early-stage breast cancer. Breast Cancer Res Treat 148:363-77
Boudreau, Denise M; Yu, Onchee; Chubak, Jessica et al. (2014) Comparative safety of cardiovascular medication use and breast cancer outcomes among women with early stage breast cancer. Breast Cancer Res Treat 144:405-16
Wirtz, Heidi S; Boudreau, Denise M; Gralow, Julie R et al. (2014) Factors associated with long-term adherence to annual surveillance mammography among breast cancer survivors. Breast Cancer Res Treat 143:541-50
Liss, David T; Fishman, Paul A; Rutter, Carolyn M et al. (2013) Outcomes among chronically ill adults in a medical home prototype. Am J Manag Care 19:e348-58

Showing the most recent 10 out of 20 publications