De NovoPost-Diagnosis Aspirin Use and Mortality in Women with Stage I–III Breast Cancer

Abstract

Background: Aspirin use has been associated with significant reductions in breast cancer-related mortality in some observational studies. However, these studies included women who initiated aspirin use before breast cancer diagnosis. It is unclear whether initiating aspirin use after diagnosis is associated with similar reductions in mortality. This study investigates associations between de novo post-diagnostic aspirin use and all cause, breast cancer-specific mortality.Methods: Women, ages 50 to 80, with a diagnosis of stage I-III breast cancer were identified from Ireland's National Cancer Registry (N ¼ 4,540). Initiation of de novo post-diagnostic aspirin use was identified from linked national prescription refill data (N ¼ 764). Adjusted HRs were estimated for associations between de novo aspirin use and all-cause, breast cancer-specific mortality.Results: The median time from diagnosis to aspirin initiation was 1.8 years. The mean number of days' supply of aspirin

Low-dose aspirin use and survival in breast cancer patients: A nationwide cohort study

“…The potential anti-cancer effect of aspirin has been hypothesised to be, in part, mediated through suppression of oestrogen biosynthesis [35,36], but similar to our study, two previous cohort studies found no difference in associations by hormone receptor status [10,17].…”

“…In our analysis, we lagged medication use after diagnosis by 6 months and this period was varied in sensitivity analysis. Other epidemiological studies have reported no association for aspirin use after diagnosis and risk of breast cancer death [15,16,17]. Similar to our investigation, these studies assessed the impact of low-dose aspirin specifically and drug use was captured using population-based prescribing databases.…”

“…This particular analysis may have been partly affected by reverse causation [12], such that the true association between aspirin and cancer-specific mortality may have been exaggerated if aspirin was withdrawn from cancer patients in whom death was suspected to be imminent [11]. In contrast to these findings, four other observational studies found little evidence of an association between aspirin use after diagnosis and breast cancer survival or recurrence [13][14][15][16][17]. A meta-analysis of 5 randomized controlled trials of low-dose aspirin to prevent vascular events showed that cancer patients (including patients with breast cancer) initiating aspirin treatment before cancer diagnosis had a reduced risk of metastasis and improved survival [18].…”

Low-dose Aspirin, Nonsteroidal Anti-inflammatory Drugs, Selective COX-2 Inhibitors and Breast Cancer Recurrence

“…23 Post-diagnostic aspirin use (both low-dose and high-dose) has been associated with a 50% reduction in breast cancer recurrence/mortality in some, 18,28 but not all studies. 19,21–25 Research on the effect of NSAIDs on breast cancer recurrence or mortality also report conflicting findings. 20–22,29,30 Decreased recurrence has been correlated with perioperative use of ketorolac 29,30 and use of any NSAID.…”

Trinucleotide repeat expansions in human breast cancer-susceptibility genes: relevant targets for aspirin chemoprevention?

“…Indeed, a relatively recent study addressed the same problem and using sophisticated methods including laser capture microdissection and next generation sequencing in breast tumor tissues versus peripheral blood DNA, it was confirmed that higher CAG repeat variants associate with risk of BC [48]. Recent studies also showed that aspirin may reduce [71] or have no influence [72] on BC-related mortality. As mentioned, the inconsistent results of epidemiological studies may relate to heterogeneous nature of investigated patient populations.…”