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Recent Prediagnostic Aspirin Use, Lymph Node Involvement, and 5-year Mortality in Women with Stage I-III Breast Cancer: a Nationwide Population-based Cohort Study

Overview
Journal Cancer Res
Specialty Oncology
Date 2014 Aug 3
PMID 25085874
Citations 18
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Abstract

Lymph node-positive breast tumors are more likely to express COX2 than node-negative tumors. In preclinical studies, COX2 inhibition prevents breast tumor spread to lymph nodes. Therefore, we examined the association between recent (1 year) prediagnostic use of aspirin (COX1/COX2 inhibitor), lymph node involvement at breast cancer diagnosis, and breast cancer-specific mortality. Women with stage I-III breast cancer diagnosed from 2001 to 2006 (N = 2,796) were identified from Ireland's National Cancer Registry. These data were linked to prescription refill and mammographic screening databases. Relative risks (RR) were estimated for associations between prediagnostic aspirin use and lymph node-positive status at diagnosis. HRs were estimated for associations between pre- and postdiagnostic aspirin use and 5-year mortality, stratified by lymph node status. Women with prediagnostic aspirin use were statistically significantly less likely to present with a lymph node-positive tumor than nonusers [RR = 0.89; 95% confidence interval (CI), 0.81-0.97], particularly those with larger (Pinteraction = 0.036), progesterone receptor (PR)-negative (Pinteraction < 0.001) or estrogen receptor (ER)-negative (Pinteraction = 0.056) tumors. The magnitude of this association increased with dose (Ptrend < 0.01) and dosing intensity (Ptrend < 0.001) and was similar in women with or without screen-detected tumors (Pinteraction = 0.70). Prediagnostic aspirin use was associated with lower 5-year breast cancer-specific mortality among women with lymph node-negative tumors (HR, 0.55; 95% CI, 0.33-0.92) but not node-positive tumors (HR, 0.91; 95% CI, 0.37-1.22). Tests for effect-modification were, however, not statistically significant (Pinteraction = 0.087). Postdiagnostic aspirin use was not associated with breast cancer-specific mortality (HR, 0.99; 95% CI, 0.68-1.45). Our findings indicate that recent prediagnostic aspirin use is protective against lymph node-positive breast cancer. This is a plausible explanation for reductions in breast cancer mortality reported in observational studies of aspirin use.

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References
1.
Johnson T, Anderson K, Lazovich D, Folsom A . Association of aspirin and nonsteroidal anti-inflammatory drug use with breast cancer. Cancer Epidemiol Biomarkers Prev. 2002; 11(12):1586-91. View

2.
Wacholder S . Binomial regression in GLIM: estimating risk ratios and risk differences. Am J Epidemiol. 1986; 123(1):174-84. DOI: 10.1093/oxfordjournals.aje.a114212. View

3.
Antoine C, Liebens F, Carly B, Pastijn A, Rozenberg S . Influence of HRT on prognostic factors for breast cancer: a systematic review after the Women's Health Initiative trial. Hum Reprod. 2004; 19(3):741-56. DOI: 10.1093/humrep/deh112. View

4.
Jurek A, Greenland S, Maldonado G, Church T . Proper interpretation of non-differential misclassification effects: expectations vs observations. Int J Epidemiol. 2005; 34(3):680-7. DOI: 10.1093/ije/dyi060. View

5.
Bastiaannet E, Sampieri K, Dekkers O, de Craen A, van Herk-Sukel M, Lemmens V . Use of aspirin postdiagnosis improves survival for colon cancer patients. Br J Cancer. 2012; 106(9):1564-70. PMC: 3341868. DOI: 10.1038/bjc.2012.101. View