breast cancer and cholesterol lowering meds

There has been a lot of confusion about the effects of cholesterol lowering medicines (statins) and breast cancer recurrence.  A recent article in the Journal of the National Cancer Institute has brought some clarity (not crystal clear just yet) to the issue.

Statin Prescriptions and Breast Cancer Recurrence Risk

A Danish Nationwide Prospective Cohort Study

Journal of the National Cancer Institute. 2011;103(19):1461-1468.

The confusion has been when the entire class of statins are analyzed for their effect on breast cancer recurrence.  As a group, statins have little if any effect on breast cancer recurrence; however, not all statins are created equal.  Some statins have no effect on breast cancer recurrence - pravastatin (Pravachol) while others clearly decrease the risk of recurrence - simvastatin (Zocor) and some falling in between - atorvastatin (Lipitor).  It turns out that the reason has to do with their chemical nature.  Lipophilic (lipid loving) statins like Zocor have less liver uptake allowing more exposure to peripheral tissues (presumably where they have their breast cancer lowering effect).  Hydrophilic (water loving) statins like Pravachol are taken up more readily in the liver decreasing their effects in pheripheral tissues and hence having no effect on breast cancer recurrence.  So if you have had breast cancer AND need your cholesterol reduced, suggest Zocor (or Lipitor) to your physician - the effects aren't huge but every little bit helps!