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Can Aspirin Reduce the Risk of Breast Cancer Recurrence?

Article date: February 16, 2010

By: Rebecca Viksnins Snowden 

Women with breast cancer who take aspirin regularly after diagnosis and treatment may have a lower risk of dying from breast cancer or seeing their breast cancer come back in distant parts of the body (known as distant recurrence), according to a new study published in The Journal of Clinical Oncology. However, experts do not recommend breast cancer patients start taking aspirin because of these findings. More research is needed to confirm any benefits, and taking aspirin regularly has known risks, including serious stomach bleeding.

The study, led by researchers from Brigham and Women’s Hospital, Dana-Farber Cancer Institute, and Harvard Medical School and funded by the National Institutes of Health, is the largest to look at whether taking aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) after breast cancer diagnosis reduces the risk of breast cancer death or distant recurrence. Previous studies have had mixed results. Some research has shown that the drugs may have a protective effect, while other studies have found no association.

What this study found

The Nurses' Health Study is a large, ongoing study investigating the role of lifestyle factors on women's health. As part of the study, researchers looked at aspirin use among 4,164 nurses aged 30 to 55 who were diagnosed with stage I, II, or III breast cancer between 1976 and 2002. The women were followed through 2006.

Most women who took aspirin regularly were taking it for heart disease prevention. The researchers found that regular aspirin users had a lower risk of distant breast cancer recurrence and breast cancer death. Women who were regular aspirin users had a nearly 50 percent lower risk of breast cancer death and risk of distant recurrence compared to those who did not take aspirin. This is the first study to suggest that taking aspirin regularly may have a survival benefit.

"This is the first study to find that aspirin can significantly reduce the risk of cancer spread and death for women who have been treated for early-stage breast cancer," said Michelle Holmes, MD, DrPH, associate professor of medicine and epidemiology at Harvard Medical School & Harvard School of Public Health and the study's lead author. "If these findings are confirmed in other clinical trials, taking aspirin may become another simple, low-cost and relatively safe tool to help women with breast cancer live longer, healthier lives."

While this study did not look at the amount of aspirin the women were taking, the typical dose used to try to prevent heart disease is about 81 mg a day.

Should you be taking aspirin?

Researchers don't know for sure how aspirin might affect cancer growth. NSAIDs inhibit the enzyme cyclooxygenase, which could play a role in disrupting breast cancer growth by suppressing estrogen synthesis. Aspirin is unique among NSAIDs: it irreversibly inhibits cyclooxygenase, which could explain its possible preventive role. Some research has suggested aspirin may affect cancer growth because of its anti-inflammatory effects (chronic inflammation has been linked to cancer). However, scientists are still investigating these processes.

In the meantime, experts caution that more studies will be needed to prove that taking aspirin reduces the risk of breast cancer recurrence or death. Taken by itself, the result of this single study should not imply that all women with breast cancer should start taking aspirin.

"If using aspirin reduces risk of disease recurrence and death in women with breast cancer, it would be of great importance to the millions of women who are breast cancer survivors. However, this is an observational study and results should be viewed cautiously," according to Eric Jacobs, PhD, American Cancer Society strategic director, pharmacoepidemiology.

"It would be premature for breast cancer survivors to use aspirin in order to reduce risk of breast cancer recurrence or of dying from their disease. Cancer survivors, as well as other adults, should discuss the risks and benefits of aspirin use with their doctor. Aspirin use can cause adverse effects, including serious gastrointestinal bleeding," says Jacobs.

The study authors caution women who are undergoing breast cancer treatment to talk to their doctors before taking aspirin – it can affect the action of other drugs.

For more information about breast cancer, see our Detailed Guide.

Citation:"Aspirin Intake and Survival After Breast Cancer." Published in the March 20, 2010,Journal of Clinical Oncology (Vol. 28, No. 9: 1467-1472). First author: Michelle Holmes, MD, DrPH, associate professor of medicine and epidemiology at Harvard Medical School & Harvard School of Public Health.

Reviewed by: Members of the ACS Medical Content Staff

ACS News Center stories are provided as a source of cancer-related news and are not intended to be used as press releases.

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