NSAIDs and breast cancer recurrence in a prospective cohort study (original) (raw)

Abstract

Objective

We examined the association between NSAID use and breast cancer recurrence in a prospective cohort of 2,292 early-stage breast cancer survivors diagnosed from 1997 to 2000 participating in the Life After Cancer Epidemiology (LACE) Study.

Methods

From 2000 to 2002, mailed questionnaires were used to obtain information on aspirin, ibuprofen, and other NSAID use and subsequent breast cancer events. A total of 270 recurrences (local, regional, and distant disease and new primary breast cancers) were reported and verified by medical record review. Cox proportional hazard models were used to estimate rate ratios (RR) and 95% confidence intervals (CI), adjusting for age at diagnosis, race, cancer stage, tamoxifen treatment, chemotherapy use, body mass index, and cyclooxygenase-2 (COX2) inhibitor use.

Results

Current, regular use (at least three days per week at time of questionnaire administration) of ibuprofen (RR, 0.56; 95% CI, 0.32–0.98), but not aspirin (RR, 1.09; 95% CI, 0.74–1.61), was associated with a statistically significant decreased risk of breast cancer recurrence. The combination of ibuprofen and other non-aspirin NSAIDs such as naproxen and sulindac reflected a similar reduction in risk (RR, 0.56; 95% CI, 0.33–0.95). No association was found for the non-NSAID analgesic acetaminophen.

Conclusion

Our findings provide support for an inverse association between current, regular ibuprofen use and breast cancer recurrence.

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References

  1. http://http://www.cancer/. (2006) org, American Cancer Society
  2. Harris RE, Chlebowski RT, Jackson RD, et al (2003) Breast cancer and nonsteroidal anti-inflammatory drugs: prospective results from the Women’s Health Initiative. Cancer Res 63(18):6096–6101
    PubMed CAS Google Scholar
  3. Khuder SA, Mutgi AB (2001) Breast cancer and NSAID use: a meta-analysis. Br J Cancer 84(9):1188–1192
    Article PubMed CAS Google Scholar
  4. Moorman PG, Grubber JM, Millikan RC, Newman B (2003) Association between non-steroidal anti-inflammatory drugs (NSAIDs) and invasive breast cancer and carcinoma in situ of the breast. Cancer Causes Control 14(10):915–922
    Article PubMed Google Scholar
  5. Swede H, Mirand AL, Menezes RJ, Moysich KB (2005) Association of regular aspirin use and breast cancer risk. Oncology 68(1): 40–47
    Article PubMed CAS Google Scholar
  6. Terry MB, Gammon MD, Zhang FF, et al (2004) Association of frequency and duration of aspirin use and hormone receptor status with breast cancer risk. Jama 291(20):2433–2440
    Article PubMed CAS Google Scholar
  7. Zhang Y, Coogan PF, Palmer JR, Strom BL, Rosenberg L (2005) Use of nonsteroidal antiinflammatory drugs and risk of breast cancer: the Case-Control Surveillance Study revisited. Am J Epidemiol 162(2):165–170
    Article PubMed Google Scholar
  8. Gonzalez-Perez A, Garcia Rodriguez LA, Lopez-Ridaura R (2003) Effects of non-steroidal anti-inflammatory drugs on cancer sites other than the colon and rectum: a meta-analysis. BMC Cancer 3:28
    Article PubMed Google Scholar
  9. Cook NR, Lee IM, Gaziano JM et al (2005) Low-dose aspirin in the primary prevention of cancer: the Women’s Health Study: a randomized controlled trial. Jama 294(1):47–55
    Article PubMed CAS Google Scholar
  10. Jacobs EJ, Thun MJ, Connell CJ et al (2005) Aspirin and other nonsteroidal anti-inflammatory drugs and breast cancer incidence in a large U.S. cohort. Cancer Epidemiol Biomarkers Prev 14(1):261–264
    PubMed CAS Google Scholar
  11. Marshall SF, Bernstein L, Anton-Culver H et al (2005) Nonsteroidal anti-inflammatory drug use and breast cancer risk by stage and hormone receptor status. J Natl Cancer Inst 97(11):805–812
    Article PubMed CAS Google Scholar
  12. Caan B, Sternfeld B, Gunderson E, Coates A, Quesenberry C, Slattery ML (2005) Life After Cancer Epidemiology (LACE) Study: a cohort of early stage breast cancer survivors (United States). Cancer Causes Control 16(5):545–556
    Article PubMed Google Scholar
  13. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. Jama 293(20):2479–2486
    Article PubMed CAS Google Scholar
  14. Hosmer DW, Lemeshow S (1999) Applied survival analysis: regression modeling of time to event data. John Wiley & Sons, Inc, New York
    Google Scholar
  15. Ulrich CM, Bigler J, Potter JD (2006) Non-steroidal anti-inflammatory drugs for cancer prevention: promise, perils and pharmacogenetics. Nat Rev Cancer 6(2):130–140
    Article PubMed CAS Google Scholar
  16. Meric JB, Rottey S, Olaussen K et al (2006) Cyclooxygenase-2 as a target for anticancer drug development. Crit Rev Oncol Hematol 59(1):51–64
    PubMed Google Scholar
  17. Alshafie GA, Harris RE, Robertson FM Parrett ML Ross M Abou-Issa H (1999) Comparative chemopreventive activity of ibuprofen and N-(4-hydroxyphenyl) retinamide against the development and growth of rat mammary adenocarcinomas. Anticancer Res 19(4B):3031–3036
    PubMed CAS Google Scholar
  18. Robertson FM, Parrett ML, Joarder FS, et al (1998) Ibuprofen-induced inhibition of cyclooxygenase isoform gene expression and regression of rat mammary carcinomas. Cancer Lett 122(1–2):165–175
    Article PubMed CAS Google Scholar
  19. Arun B, Hortobagyi GN (2002) Progress in breast cancer chemoprevention. Endocr Relat Cancer 9(1):15–32
    Article PubMed CAS Google Scholar
  20. Hwang D, Scollard D, Byrne J, Levine E (1998) Expression of cyclooxygenase-1 and cyclooxygenase-2 in human breast cancer. J Natl Cancer Inst 90(6):455–460
    Article PubMed CAS Google Scholar
  21. Parrett M, Harris R, Joarder F, Ross M, Clausen K, Robertson F (1997) Cyclooxygenase-2 gene expression in human breast cancer. Int J Oncol 10:503–508
    CAS Google Scholar
  22. Costa C, Soares R, Reis-Filho JS, Leitao D, Amendoeira I, Schmitt FC (2002) Cyclo-oxygenase 2 expression is associated with angiogenesis and lymph node metastasis in human breast cancer. J Clin Pathol 55(6):429–434
    PubMed CAS Google Scholar
  23. Ristimaki A, Sivula A, Lundin J, et al (2002) Prognostic significance of elevated cyclooxygenase-2 expression in breast cancer. Cancer Res 62(3):632–635
    PubMed CAS Google Scholar
  24. Blair CK, Sweeney C, Anderson KE, Folsom AR (2006) NSAID use and survival after breast cancer diagnosis in post-menopausal women_._ Breast Cancer Res Treat

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Acknowledgments

This study was funded by the National Cancer Institute (R01 CA80027) and by the Utah Cancer Registry (N01 PC67000), with additional support from the State of Utah Department of Health. We thank Charles Quesenberry, Ph.D. for his biostatistical support and Robert Reynolds, M.P.H. for his programming support. We thank all LACE Study staff and participants.

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Authors and Affiliations

  1. Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA
    Marilyn L. Kwan, Laurel A. Habel & Bette Caan
  2. University of Utah, 375 Chipeta Way, Ste A, Salt Lake City, UT, 84108, USA
    Martha L. Slattery

Authors

  1. Marilyn L. Kwan
  2. Laurel A. Habel
  3. Martha L. Slattery
  4. Bette Caan

Corresponding author

Correspondence toMarilyn L. Kwan.

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Kwan, M.L., Habel, L.A., Slattery, M.L. et al. NSAIDs and breast cancer recurrence in a prospective cohort study.Cancer Causes Control 18, 613–620 (2007). https://doi.org/10.1007/s10552-007-9003-y

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