Regular use of aspirin and other non-steroidal anti-inflammatory drugs and breast cancer risk for women at familial or genetic risk: A cohort study

Rebecca D. Kehm, John L. Hopper, Esther M. John, Kelly Anne Phillips, Robert J. MacInnis, Gillian S. Dite, Roger L. Milne, Yuyan Liao, Nur Zeinomar, Julia A. Knight, Melissa C. Southey, Linda Vahdat, Naomi Kornhauser, Tessa Cigler, Wendy K. Chung, Graham G. Giles, Sue Anne McLachlan, Michael L. Friedlander, Prue C. Weideman, Gord Glendon & 6 others Stephanie Nesci, kConFab Investigators, Irene L. Andrulis, Saundra S. Buys, Mary B. Daly, Mary Beth Terry

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: The use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced breast cancer risk, but it is not known if this association extends to women at familial or genetic risk. We examined the association between regular NSAID use and breast cancer risk using a large cohort of women selected for breast cancer family history, including 1054 BRCA1 or BRCA2 mutation carriers. Methods: We analyzed a prospective cohort (N = 5606) and a larger combined, retrospective and prospective, cohort (N = 8233) of women who were aged 18 to 79 years, enrolled before June 30, 2011, with follow-up questionnaire data on medication history. The prospective cohort was further restricted to women without breast cancer when medication history was asked by questionnaire. Women were recruited from seven study centers in the United States, Canada, and Australia. Associations were estimated using multivariable Cox proportional hazards regression models adjusted for demographics, lifestyle factors, family history, and other medication use. Women were classified as regular or non-regular users of aspirin, COX-2 inhibitors, ibuprofen and other NSAIDs, and acetaminophen (control) based on self-report at follow-up of ever using the medication for at least twice a week for ≥1 month prior to breast cancer diagnosis. The main outcome was incident invasive breast cancer, based on self- or relative-report (81% confirmed pathologically). Results: From fully adjusted analyses, regular aspirin use was associated with a 39% and 37% reduced risk of breast cancer in the prospective (HR = 0.61; 95% CI = 0.33-1.14) and combined cohorts (HR = 0.63; 95% CI = 0.57-0.71), respectively. Regular use of COX-2 inhibitors was associated with a 61% and 71% reduced risk of breast cancer (prospective HR = 0.39; 95% CI = 0.15-0.97; combined HR = 0.29; 95% CI = 0.23-0.38). Other NSAIDs and acetaminophen were not associated with breast cancer risk in either cohort. Associations were not modified by familial risk, and consistent patterns were found by BRCA1 and BRCA2 carrier status, estrogen receptor status, and attained age. Conclusion: Regular use of aspirin and COX-2 inhibitors might reduce breast cancer risk for women at familial or genetic risk.

Original languageEnglish
Article number52
Number of pages13
JournalBreast Cancer Research
Volume21
Issue number1
DOIs
Publication statusPublished - 18 Apr 2019

Keywords

  • Breast cancer
  • Family history
  • High-risk population
  • Non-steroidal anti-inflammatory drugs

Cite this

Kehm, Rebecca D. ; Hopper, John L. ; John, Esther M. ; Phillips, Kelly Anne ; MacInnis, Robert J. ; Dite, Gillian S. ; Milne, Roger L. ; Liao, Yuyan ; Zeinomar, Nur ; Knight, Julia A. ; Southey, Melissa C. ; Vahdat, Linda ; Kornhauser, Naomi ; Cigler, Tessa ; Chung, Wendy K. ; Giles, Graham G. ; McLachlan, Sue Anne ; Friedlander, Michael L. ; Weideman, Prue C. ; Glendon, Gord ; Nesci, Stephanie ; kConFab Investigators ; Andrulis, Irene L. ; Buys, Saundra S. ; Daly, Mary B. ; Terry, Mary Beth. / Regular use of aspirin and other non-steroidal anti-inflammatory drugs and breast cancer risk for women at familial or genetic risk : A cohort study. In: Breast Cancer Research. 2019 ; Vol. 21, No. 1.
@article{dec5461440ff4d7a85fe8781ec443f16,
title = "Regular use of aspirin and other non-steroidal anti-inflammatory drugs and breast cancer risk for women at familial or genetic risk: A cohort study",
abstract = "Background: The use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced breast cancer risk, but it is not known if this association extends to women at familial or genetic risk. We examined the association between regular NSAID use and breast cancer risk using a large cohort of women selected for breast cancer family history, including 1054 BRCA1 or BRCA2 mutation carriers. Methods: We analyzed a prospective cohort (N = 5606) and a larger combined, retrospective and prospective, cohort (N = 8233) of women who were aged 18 to 79 years, enrolled before June 30, 2011, with follow-up questionnaire data on medication history. The prospective cohort was further restricted to women without breast cancer when medication history was asked by questionnaire. Women were recruited from seven study centers in the United States, Canada, and Australia. Associations were estimated using multivariable Cox proportional hazards regression models adjusted for demographics, lifestyle factors, family history, and other medication use. Women were classified as regular or non-regular users of aspirin, COX-2 inhibitors, ibuprofen and other NSAIDs, and acetaminophen (control) based on self-report at follow-up of ever using the medication for at least twice a week for ≥1 month prior to breast cancer diagnosis. The main outcome was incident invasive breast cancer, based on self- or relative-report (81{\%} confirmed pathologically). Results: From fully adjusted analyses, regular aspirin use was associated with a 39{\%} and 37{\%} reduced risk of breast cancer in the prospective (HR = 0.61; 95{\%} CI = 0.33-1.14) and combined cohorts (HR = 0.63; 95{\%} CI = 0.57-0.71), respectively. Regular use of COX-2 inhibitors was associated with a 61{\%} and 71{\%} reduced risk of breast cancer (prospective HR = 0.39; 95{\%} CI = 0.15-0.97; combined HR = 0.29; 95{\%} CI = 0.23-0.38). Other NSAIDs and acetaminophen were not associated with breast cancer risk in either cohort. Associations were not modified by familial risk, and consistent patterns were found by BRCA1 and BRCA2 carrier status, estrogen receptor status, and attained age. Conclusion: Regular use of aspirin and COX-2 inhibitors might reduce breast cancer risk for women at familial or genetic risk.",
keywords = "Breast cancer, Family history, High-risk population, Non-steroidal anti-inflammatory drugs",
author = "Kehm, {Rebecca D.} and Hopper, {John L.} and John, {Esther M.} and Phillips, {Kelly Anne} and MacInnis, {Robert J.} and Dite, {Gillian S.} and Milne, {Roger L.} and Yuyan Liao and Nur Zeinomar and Knight, {Julia A.} and Southey, {Melissa C.} and Linda Vahdat and Naomi Kornhauser and Tessa Cigler and Chung, {Wendy K.} and Giles, {Graham G.} and McLachlan, {Sue Anne} and Friedlander, {Michael L.} and Weideman, {Prue C.} and Gord Glendon and Stephanie Nesci and {kConFab Investigators} and Andrulis, {Irene L.} and Buys, {Saundra S.} and Daly, {Mary B.} and Terry, {Mary Beth}",
year = "2019",
month = "4",
day = "18",
doi = "10.1186/s13058-019-1135-y",
language = "English",
volume = "21",
journal = "Breast Cancer Research",
issn = "1465-5411",
publisher = "Springer-Verlag London Ltd.",
number = "1",

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Kehm, RD, Hopper, JL, John, EM, Phillips, KA, MacInnis, RJ, Dite, GS, Milne, RL, Liao, Y, Zeinomar, N, Knight, JA, Southey, MC, Vahdat, L, Kornhauser, N, Cigler, T, Chung, WK, Giles, GG, McLachlan, SA, Friedlander, ML, Weideman, PC, Glendon, G, Nesci, S, kConFab Investigators, Andrulis, IL, Buys, SS, Daly, MB & Terry, MB 2019, 'Regular use of aspirin and other non-steroidal anti-inflammatory drugs and breast cancer risk for women at familial or genetic risk: A cohort study' Breast Cancer Research, vol. 21, no. 1, 52. https://doi.org/10.1186/s13058-019-1135-y

Regular use of aspirin and other non-steroidal anti-inflammatory drugs and breast cancer risk for women at familial or genetic risk : A cohort study. / Kehm, Rebecca D.; Hopper, John L.; John, Esther M.; Phillips, Kelly Anne; MacInnis, Robert J.; Dite, Gillian S.; Milne, Roger L.; Liao, Yuyan; Zeinomar, Nur; Knight, Julia A.; Southey, Melissa C.; Vahdat, Linda; Kornhauser, Naomi; Cigler, Tessa; Chung, Wendy K.; Giles, Graham G.; McLachlan, Sue Anne; Friedlander, Michael L.; Weideman, Prue C.; Glendon, Gord; Nesci, Stephanie; kConFab Investigators; Andrulis, Irene L.; Buys, Saundra S.; Daly, Mary B.; Terry, Mary Beth.

In: Breast Cancer Research, Vol. 21, No. 1, 52, 18.04.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Regular use of aspirin and other non-steroidal anti-inflammatory drugs and breast cancer risk for women at familial or genetic risk

T2 - A cohort study

AU - Kehm, Rebecca D.

AU - Hopper, John L.

AU - John, Esther M.

AU - Phillips, Kelly Anne

AU - MacInnis, Robert J.

AU - Dite, Gillian S.

AU - Milne, Roger L.

AU - Liao, Yuyan

AU - Zeinomar, Nur

AU - Knight, Julia A.

AU - Southey, Melissa C.

AU - Vahdat, Linda

AU - Kornhauser, Naomi

AU - Cigler, Tessa

AU - Chung, Wendy K.

AU - Giles, Graham G.

AU - McLachlan, Sue Anne

AU - Friedlander, Michael L.

AU - Weideman, Prue C.

AU - Glendon, Gord

AU - Nesci, Stephanie

AU - kConFab Investigators

AU - Andrulis, Irene L.

AU - Buys, Saundra S.

AU - Daly, Mary B.

AU - Terry, Mary Beth

PY - 2019/4/18

Y1 - 2019/4/18

N2 - Background: The use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced breast cancer risk, but it is not known if this association extends to women at familial or genetic risk. We examined the association between regular NSAID use and breast cancer risk using a large cohort of women selected for breast cancer family history, including 1054 BRCA1 or BRCA2 mutation carriers. Methods: We analyzed a prospective cohort (N = 5606) and a larger combined, retrospective and prospective, cohort (N = 8233) of women who were aged 18 to 79 years, enrolled before June 30, 2011, with follow-up questionnaire data on medication history. The prospective cohort was further restricted to women without breast cancer when medication history was asked by questionnaire. Women were recruited from seven study centers in the United States, Canada, and Australia. Associations were estimated using multivariable Cox proportional hazards regression models adjusted for demographics, lifestyle factors, family history, and other medication use. Women were classified as regular or non-regular users of aspirin, COX-2 inhibitors, ibuprofen and other NSAIDs, and acetaminophen (control) based on self-report at follow-up of ever using the medication for at least twice a week for ≥1 month prior to breast cancer diagnosis. The main outcome was incident invasive breast cancer, based on self- or relative-report (81% confirmed pathologically). Results: From fully adjusted analyses, regular aspirin use was associated with a 39% and 37% reduced risk of breast cancer in the prospective (HR = 0.61; 95% CI = 0.33-1.14) and combined cohorts (HR = 0.63; 95% CI = 0.57-0.71), respectively. Regular use of COX-2 inhibitors was associated with a 61% and 71% reduced risk of breast cancer (prospective HR = 0.39; 95% CI = 0.15-0.97; combined HR = 0.29; 95% CI = 0.23-0.38). Other NSAIDs and acetaminophen were not associated with breast cancer risk in either cohort. Associations were not modified by familial risk, and consistent patterns were found by BRCA1 and BRCA2 carrier status, estrogen receptor status, and attained age. Conclusion: Regular use of aspirin and COX-2 inhibitors might reduce breast cancer risk for women at familial or genetic risk.

AB - Background: The use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced breast cancer risk, but it is not known if this association extends to women at familial or genetic risk. We examined the association between regular NSAID use and breast cancer risk using a large cohort of women selected for breast cancer family history, including 1054 BRCA1 or BRCA2 mutation carriers. Methods: We analyzed a prospective cohort (N = 5606) and a larger combined, retrospective and prospective, cohort (N = 8233) of women who were aged 18 to 79 years, enrolled before June 30, 2011, with follow-up questionnaire data on medication history. The prospective cohort was further restricted to women without breast cancer when medication history was asked by questionnaire. Women were recruited from seven study centers in the United States, Canada, and Australia. Associations were estimated using multivariable Cox proportional hazards regression models adjusted for demographics, lifestyle factors, family history, and other medication use. Women were classified as regular or non-regular users of aspirin, COX-2 inhibitors, ibuprofen and other NSAIDs, and acetaminophen (control) based on self-report at follow-up of ever using the medication for at least twice a week for ≥1 month prior to breast cancer diagnosis. The main outcome was incident invasive breast cancer, based on self- or relative-report (81% confirmed pathologically). Results: From fully adjusted analyses, regular aspirin use was associated with a 39% and 37% reduced risk of breast cancer in the prospective (HR = 0.61; 95% CI = 0.33-1.14) and combined cohorts (HR = 0.63; 95% CI = 0.57-0.71), respectively. Regular use of COX-2 inhibitors was associated with a 61% and 71% reduced risk of breast cancer (prospective HR = 0.39; 95% CI = 0.15-0.97; combined HR = 0.29; 95% CI = 0.23-0.38). Other NSAIDs and acetaminophen were not associated with breast cancer risk in either cohort. Associations were not modified by familial risk, and consistent patterns were found by BRCA1 and BRCA2 carrier status, estrogen receptor status, and attained age. Conclusion: Regular use of aspirin and COX-2 inhibitors might reduce breast cancer risk for women at familial or genetic risk.

KW - Breast cancer

KW - Family history

KW - High-risk population

KW - Non-steroidal anti-inflammatory drugs

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U2 - 10.1186/s13058-019-1135-y

DO - 10.1186/s13058-019-1135-y

M3 - Article

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JO - Breast Cancer Research

JF - Breast Cancer Research

SN - 1465-5411

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ER -