© 2005 Oxford University Press
ARTICLE |
Nonsteroidal Anti-Inflammatory Drug Use and Breast Cancer Risk by Stage and Hormone Receptor Status
Affiliations of authors: Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA (SFM, LB, DD, RP, DS, RKR); Cancer Surveillance Section, Sacramento, CA (WEW); School of Medicine, University of California, Irvine, CA (HA-C, HM, DP, AZ); Northern California Cancer Center, Fremont, CA (PLH-R, DMP, DW); Environmental Health Investigations Branch, California Department of Health Services, Oakland, CA (PR)
Correspondence to: Sarah F. Marshall, Department of Preventive Medicine, University of Southern California, 1420 San Pablo Street, PMB-B105, Los Angeles, CA 90033 (e-mail: smarshal{at}usc.edu).
Background: Epidemiologic studies of the association between nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, and breast cancer risk have yielded inconsistent results. We investigated the association of NSAID use with risk of breast cancer in the California Teachers Study cohort, with special attention to risk of specific breast cancer subtypes and to type of NSAID used. Methods: We analyzed data on 114 460 women in the California Teachers Study cohort who were aged 22 to 85 years and free of breast cancer at baseline in 1995 to 1996. Information on frequency and duration of NSAID use was collected through a self-administered questionnaire. A total of 2391 women were diagnosed with breast cancer during the follow-up period from 1995 to 2001. We used Cox proportional hazards regression to estimate relative risks (RR) and 95% confidence intervals (CI) of breast cancer subtypes with NSAID use. Results: Neither regular use (more than once a week) of any NSAID (aspirin and ibuprofen combined) nor regular use of aspirin was associated with breast cancer risk (RR = 1.09, 95% CI = 0.97 to 1.21 for daily versus no regular use of NSAIDs and RR = 0.98, 95% CI = 0.86 to 1.13 for daily versus no regular use of aspirin). However, long-term (
5 years) daily aspirin users had a non–statistically significant decreased risk of estrogen receptor and progesterone receptor (ER/PR)–positive breast cancer (RR = 0.80, 95% CI = 0.62 to 1.03). In contrast, we observed a statistically significantly increased risk of ER/PR-negative breast cancer with long-term daily use of aspirin (RR = 1.81, 95% CI = 1.12 to 2.92). In this population, 11 fewer ER/PR-positive breast cancer cases and seven excess ER/PR-negative breast cancer cases may be due to daily long-term aspirin use among 2391 breast cancer cases observed over 6 years if the association were proven to be causal. Long-term daily use of ibuprofen was also associated with an increased risk of breast cancer (RR = 1.51, 95% CI = 1.17 to 1.95), particularly of nonlocalized tumors (RR = 1.92, 95% CI = 1.24 to 2.97). If causality were subsequently proven, 16 of the observed 2391 breast cancer cases and 8 of the 713 non-localized breast cancer cases would be attributable to long-term daily use of ibuprofen. Conclusions: Long-term daily use of NSAIDs was not associated with breast cancer risk overall. Ibuprofen use was associated with an increased risk of breast cancer, and long-term daily aspirin use was associated with an increased risk of ER/PR-negative breast cancer. However, it is not clear if the observed association is causal.
CiteULike 
Connotea 
Del.icio.us What's this?
Find additional patient-related information at:
This article has been cited by other articles:
|
|
 |
|
  J. E. Abraham, P. Harrington, K. E. Driver, J. Tyrer, D. F. Easton, A. M. Dunning, and P. D.P. Pharoah Common Polymorphisms in the Prostaglandin Pathway Genes and Their Association with Breast Cancer Susceptibility and Survival Clin. Cancer Res., March 15, 2009; 15(6): 2181 - 2191. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. Eliassen, W. Y. Chen, D. Spiegelman, W. C. Willett, D. J. Hunter, and S. E. Hankinson Use of Aspirin, Other Nonsteroidal Anti-inflammatory Drugs, and Acetaminophen and Risk of Breast Cancer Among Premenopausal Women in the Nurses' Health Study II Arch Intern Med, January 26, 2009; 169(2): 115 - 121. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. Mathes, K. E. Malone, J. R. Daling, S. Davis, S. M. Lucas, P. L. Porter, and C. I. Li Migraine in Postmenopausal Women and the Risk of Invasive Breast Cancer Cancer Epidemiol. Biomarkers Prev., November 1, 2008; 17(11): 3116 - 3122. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Takkouche, C. Regueira-Mendez, and M. Etminan Breast Cancer and Use of Nonsteroidal Anti-inflammatory Drugs: A Meta-analysis J Natl Cancer Inst, October 15, 2008; 100(20): 1439 - 1447. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. R. Howe and S. M. Lippman Modulation of Breast Cancer Risk by Nonsteroidal Anti-inflammatory Drugs J Natl Cancer Inst, October 15, 2008; 100(20): 1420 - 1423. [Full Text] [PDF]
|
|
|
|
|
|
K. B. Moysich, G. P. Beehler, G. Zirpoli, J.-Y. Choi, and J. A. Baker Use of Common Medications and Breast Cancer Risk Cancer Epidemiol. Biomarkers Prev., July 1, 2008; 17(7): 1564 - 1595. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Terry, D. S.M. Buist, A. Trentham-Dietz, T. M. James-Todd, and Y. Liao Nonsteroidal Anti-inflammatory Drugs and Change in Mammographic Density: A Cohort Study Using Pharmacy Records on Over 29,000 Postmenopausal Women Cancer Epidemiol. Biomarkers Prev., May 1, 2008; 17(5): 1088 - 1095. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. G. Hudson, G. L. Gierach, F. Modugno, J. Simpson, J. W. Wilson, R. W. Evans, V. G. Vogel, and J. L. Weissfeld Nonsteroidal Anti-inflammatory Drug Use and Serum Total Estradiol in Postmenopausal Women Cancer Epidemiol. Biomarkers Prev., March 1, 2008; 17(3): 680 - 687. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. Gill, G. Maskarinec, L. R. Wilkens, M. C. Pike, B. E. Henderson, and L. N. Kolonel Nonsteroidal Antiinflammatory Drugs and Breast Cancer Risk: The Multiethnic Cohort Am. J. Epidemiol., November 15, 2007; 166(10): 1150 - 1158. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. A. Kirsh, N. Kreiger, M. Cotterchio, M. Sloan, and B. Theis Nonsteroidal Antiinflammatory Drug Use and Breast Cancer Risk: Subgroup Findings Am. J. Epidemiol., September 15, 2007; 166(6): 709 - 716. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Bardia, J. O. Ebbert, R. A. Vierkant, P. J. Limburg, K. Anderson, A. H. Wang, J. E. Olson, C. M. Vachon, and J. R. Cerhan Association of Aspirin and Nonaspirin Nonsteroidal Anti-inflammatory Drugs With Cancer Incidence and Mortality J Natl Cancer Inst, June 6, 2007; 99(11): 881 - 889. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Zhang, J. Lin, N. R. Cook, I-M. Lee, J. E. Manson, J. E. Buring, and P. M. Ridker C-Reactive Protein and Risk of Breast Cancer J Natl Cancer Inst, June 6, 2007; 99(11): 890 - 894. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Slattery, K. Curtin, R. Baumgartner, C. Sweeney, T. Byers, A. R. Giuliano, K. B. Baumgartner, and R. R. Wolff IL6, Aspirin, Nonsteroidal Anti-inflammatory Drugs, and Breast Cancer Risk in Women Living in the Southwestern United States Cancer Epidemiol. Biomarkers Prev., April 1, 2007; 16(4): 747 - 755. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Vogel, J. Christensen, B. A Nexo, H. Wallin, S. Friis, and A. Tjonneland Peroxisome profilerator-activated receptor{gamma}2 Pro12Ala, interaction with alcohol intake and NSAID use, in relation to risk of breast cancer in a prospective study of Danes Carcinogenesis, February 1, 2007; 28(2): 427 - 434. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. R. Howe, S.-H. Chang, K. C. Tolle, R. Dillon, L. J.T. Young, R. D. Cardiff, R. A. Newman, P. Yang, H. T. Thaler, W. J. Muller, et al. HER2/neu-Induced Mammary Tumorigenesis and Angiogenesis Are Reduced in Cyclooxygenase-2 Knockout Mice Cancer Res., November 1, 2005; 65(21): 10113 - 10119. [Abstract] [Full Text] [PDF]
|
|