Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
J Clin Oncol. 2010 Mar 20;28(9):1467-72. doi: 10.1200/JCO.2009.22.7918. Epub 2010 Feb 16.
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.
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.
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.
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.
动物和体外研究表明阿司匹林可能抑制乳腺癌转移。我们研究了乳腺癌患者使用阿司匹林是否降低了其死于乳腺癌的风险。
这是一项基于参加护士健康研究的 4164 名女性注册护士的前瞻性观察性研究,这些护士于 1976 年至 2002 年期间被诊断患有 I 期、II 期或 III 期乳腺癌,随访至死亡或 2006 年 6 月,以先发生者为准。主要结局是根据确诊后至少 12 个月首次评估的每周使用阿司匹林天数(0、1、2 至 5 或 6 至 7 天),评估乳腺癌死亡风险,并进行更新。
共有 341 例乳腺癌死亡。阿司匹林的使用与乳腺癌死亡风险降低相关。与不使用阿司匹林相比,每周使用阿司匹林 1、2 至 5 和 6 至 7 天的调整后相对风险(RR)分别为 1.07(95%CI,0.70 至 1.63)、0.29(95%CI,0.16 至 0.52)和 0.36(95%CI,0.24 至 0.54)(线性趋势检验,P<0.001)。这种关联在疾病分期、绝经状态、体重指数或雌激素受体状态方面差异不大。远处复发的结果也相似。调整后的 RR 分别为 0.91(95%CI,0.62 至 1.33)、0.40(95%CI,0.24 至 0.65)和 0.57(95%CI,0.39 至 0.82;趋势检验,P=0.03),与每周使用阿司匹林 1、2 至 5 和 6 至 7 天有关。
在乳腺癌确诊至少 1 年后仍存活的女性中,阿司匹林的使用与远处复发和乳腺癌死亡风险降低相关。