BETA-BLOCKER USE AND BREAST CANCER OUTCOMES: A SCOPING REVIEW
Author(s)
Jieni Li, PhD, MPH, Yinan Wang, PhD, MPP, Meghana Trivedi, PhD, PharmD, Rajender R. Aparasu, PhD, FAPhA.
University of Houston, Houston, TX, USA.
University of Houston, Houston, TX, USA.
OBJECTIVES: Beta-blockers (BBs) are widely used to treat cardiovascular conditions, as they inhibit β-adrenergic signaling pathways. Breast cancer (BC) cells also express beta-adrenergic receptors, and their activation leads to upregulated expression of metastasis-associated genes. Several observational studies evaluated the association between BB use and BC-related outcomes. This systematic review examined the evidence of association between BB use and BC-related outcomes, including BC progression, BC-specific mortality, and overall mortality.
METHODS: We conducted a systematic literature search in PubMed and Embase until August 2025. Our keywords included key terms for BC and BBs. We included observational studies that evaluated the use of BB and BC-related outcomes. Studies were excluded if they were reviews or involved non-human subjects. Data extraction focused on patient demographics, type of BB use, BC-related characteristics, and the key study findings.
RESULTS: From 452 unique studies screened, 40 full-text articles were assessed for eligibility, and 16 studies met the inclusion criteria. The included studies were conducted across Europe, North America, Oceania, and Asia, with study periods ranging from the 1980s to the 2020s. The positive estrogen receptor population is the most commonly studied among eligible studies. Atenolol and propranolol were the most frequently investigated agents; however, information on dose, frequency, and adherence was not reported in most studies. Most studies (93.8%) are cohort studies, and one study used a case-control design. Among 11 studies examining BC-specific mortality, three (27.27%) found a protective association with BB use. Of the three studies investigating BC progression, two (66.67%) reported reduced BC progression. Of the eight studies assessed overall mortality, three (37.5%) found that BBs significantly increased overall mortality.
CONCLUSIONS: Overall, observational studies suggest possible improvement in BC-specific outcomes but may worsen overall survival among BB users. Further pre-clinical and population-based studies are needed to inform and support the repurposing of BBs in BC care.
METHODS: We conducted a systematic literature search in PubMed and Embase until August 2025. Our keywords included key terms for BC and BBs. We included observational studies that evaluated the use of BB and BC-related outcomes. Studies were excluded if they were reviews or involved non-human subjects. Data extraction focused on patient demographics, type of BB use, BC-related characteristics, and the key study findings.
RESULTS: From 452 unique studies screened, 40 full-text articles were assessed for eligibility, and 16 studies met the inclusion criteria. The included studies were conducted across Europe, North America, Oceania, and Asia, with study periods ranging from the 1980s to the 2020s. The positive estrogen receptor population is the most commonly studied among eligible studies. Atenolol and propranolol were the most frequently investigated agents; however, information on dose, frequency, and adherence was not reported in most studies. Most studies (93.8%) are cohort studies, and one study used a case-control design. Among 11 studies examining BC-specific mortality, three (27.27%) found a protective association with BB use. Of the three studies investigating BC progression, two (66.67%) reported reduced BC progression. Of the eight studies assessed overall mortality, three (37.5%) found that BBs significantly increased overall mortality.
CONCLUSIONS: Overall, observational studies suggest possible improvement in BC-specific outcomes but may worsen overall survival among BB users. Further pre-clinical and population-based studies are needed to inform and support the repurposing of BBs in BC care.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO25
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Oncology