Aspirin Intake and Survival After Breast Cancer — JCO

Aspirin Intake and Survival After Breast Cancer
Michelle D. Holmes, Wendy Y. Chen, Lisa Li, Ellen Hertzmark, Donna Spiegelman and Susan E. Hankinson
+ Author Affiliations

From the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Department of Medical Oncology, Dana-Farber Cancer Institute; and Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Boston, MA.
Corresponding author: Michelle D. Holmes, MD, DrPH, Channing Laboratory, 181 Longwood Ave, Boston, MA 02115; e-mail: michelle.holmes@channing.harvard.edu.

Abstract
Purpose Animal and in vitro studies suggest that aspirin may inhibit breast cancer metastasis. We studied whether aspirin use among women with breast cancer decreased their risk of death from breast cancer.

Methods This was a prospective observational study based on responses from 4,164 female registered nurses in the Nurses' Health Study who were diagnosed with stages I, II, or III breast cancer between 1976 and 2002 and were observed until death or June 2006, whichever came first. The main outcome was breast cancer mortality risk according to number of days per week of aspirin use (0, 1, 2 to 5, or 6 to 7 days) first assessed at least 12 months after diagnosis and updated.

Results There were 341 breast cancer deaths. Aspirin use was associated with a decreased risk of breast cancer death. The adjusted relative risks (RRs) for 1, 2 to 5, and 6 to 7 days of aspirin use per week compared with no use were 1.07 (95% CI, 0.70 to 1.63), 0.29 (95% CI, 0.16 to 0.52), and 0.36 (95% CI, 0.24 to 0.54), respectively (test for linear trend, P < .001). This association did not differ appreciably by stage, menopausal status, body mass index, or estrogen receptor status. Results were similar for distant recurrence. The adjusted RRs were 0.91 (95% CI, 0.62 to 1.33), 0.40 (95% CI, 0.24 to 0.65), and 0.57 (95% CI, 0.39 to 0.82; test for trend, P = .03) for 1, 2 to 5, and 6 to 7 days of aspirin use, respectively.

Conclusion Among women living at least 1 year after a breast cancer diagnosis, aspirin use was associated with a decreased risk of distant recurrence and breast cancer death.

Footnotes
Supported by National Institutes of Health Grant No. CA87969.

The National Institutes of Health had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, and approval of the manuscript.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.
•Received February 25, 2009.
•Accepted December 9, 2009.

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Aspirin Intake and Survival After Breast Cancer — JCO