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Breast cancer tends to arise in older women who are also burdened with comorbidities such as cardiovascular disease (CVD). Increasing numbers of breast cancer survivors and an aging population warrant a better understanding of CVD management and adherence to preventive therapies. We estimated adherence to statins and therapeutic goal lipid values during the year before breast cancer diagnosis or baseline, treatment period, and in subsequent years of clinical management among breast cancer survivors. We sampled women from an existing cohort of 4,221 women diagnosed with incident early stage (I, II) invasive breast cancer from 1990 to 2008 and enrolled in a large integrated group practice health plan. Among prevalent statin users (N = 1,393), medication adherence and persistence were measured by medication possession ratio (MPR), % adherent (MPR < 0.80), and discontinuation rates …