Brigham and Women's Hospital and Harvard Medical School, Channing Laboratory at Landmark Center, 401 Park Dr, Boston, MA 02115, USA.
J Clin Oncol. 2012 Oct 1;30(28):3468-77. doi: 10.1200/JCO.2012.42.2006. Epub 2012 Aug 27.
The associations between use of aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen and breast cancer incidence in postmenopausal women are uncertain. We examined these associations with breast cancer, both overall and by molecular subtype.
We observed 84,602 postmenopausal women, free of cancer in 1980, until June 2008 and prospectively collected data on analgesic use, reproductive history, and other lifestyle factors using biennial questionnaires. Proportional hazards models were used to estimate multivariable relative risks (RRs) and 95% CIs.
We documented 4,734 cases of incident invasive breast cancer. Compared with nonuse of aspirin, multivariable RRs of regular aspirin use (≥ two tablets per week) for more than 20 years were 0.91 for overall breast cancer (95% CI, 0.81 to 1.01; P(trend) = 0.16), 0.90 for estrogen receptor (ER) -positive progesterone receptor (PR) -positive breast cancer (95% CI, 0.77 to 1.06; P(trend) = 0.17), and 0.91 for ER-negative PR-negative breast cancer (95% CI, 0.68 to 1.22; P(trend) = 0.97). Results did not vary appreciably by past or current use, days per week of use, or dosage of use. Use of other NSAIDs and acetaminophen was largely not significantly associated with breast cancer risk. Additionally, use of higher doses of each analgesic (≥ six tablets per week) for more than 10 years was generally not significantly associated with risk of breast cancer, either overall or by subtype. Furthermore, largely no substantial associations were noted for breast cancer molecular subtypes, including luminal A, luminal B, triple negative, basal-like, human epidermal growth factor receptor 2 positive, cyclooxygenase-2 (COX-2) negative, and COX-2 positive.
Our study suggests that use of aspirin, other NSAIDs, and acetaminophen is not importantly associated with risk of postmenopausal breast cancer, either overall or by specific subtype.
阿司匹林、其他非甾体抗炎药（NSAIDs）和对乙酰氨基酚的使用与绝经后妇女乳腺癌的发生之间的关联尚不确定。我们通过乳腺癌的整体情况和分子亚型来研究这些关联。
我们观察了 84602 名 1980 年无癌症的绝经后妇女，前瞻性地收集了使用双年问卷的镇痛药使用、生殖史和其他生活方式因素的数据。使用比例风险模型估计多变量相对风险（RR）和 95%置信区间（CI）。
我们记录了 4734 例新发浸润性乳腺癌病例。与不使用阿司匹林相比，长期（超过 20 年）规律使用阿司匹林（每周≥两片）的多变量 RR 为 0.91（95%CI，0.81 至 1.01；P（趋势）=0.16），用于治疗整体乳腺癌，0.90 用于雌激素受体（ER）阳性孕激素受体（PR）阳性乳腺癌（95%CI，0.77 至 1.06；P（趋势）=0.17），0.91 用于 ER 阴性 PR 阴性乳腺癌（95%CI，0.68 至 1.22；P（趋势）=0.97）。结果在过去或现在的使用、每周使用天数或使用剂量方面没有明显差异。其他 NSAIDs 和对乙酰氨基酚的使用与乳腺癌风险的相关性不大。此外，每种镇痛药（每周≥六片）使用超过 10 年的较高剂量通常与乳腺癌的总体或亚型风险无关。此外，对于乳腺癌的分子亚型，包括 luminal A、luminal B、三阴性、基底样、人表皮生长因子受体 2 阳性、环氧化酶-2（COX-2）阴性和 COX-2 阳性，也没有明显的关联。
我们的研究表明，阿司匹林、其他 NSAIDs 和对乙酰氨基酚的使用与绝经后妇女乳腺癌的总体或特定亚型的风险无关。
