Johns Christopher, Yen Allen, Rahimi Asal, Liu Yu-Lun, Leitch Ann Marilyn, Spangler Ann, Alluri Prasanna, Nwachukwu Chika, Wooldridge Rachel, Farr Deborah, Kim D W Nathan
Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, USA.
Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, USA.
J Breast Cancer. 2023 Feb;26(1):14-24. doi: 10.4048/jbc.2023.26.e3. Epub 2023 Jan 25.
Inflammatory breast cancer (IBC) is the most aggressive form of breast cancer and has a high propensity for distant metastases. Our previous data suggested that aspirin (acetylsalicylic acid, ASA) use may be associated with reduced risk of distant metastases in aggressive breast cancer; however, there are no reported studies on the potential benefit of ASA use in patients with IBC.
Data from patients with non-metastatic IBC treated between 2000-2017 at two institutions, were reviewed. Overall survival (OS), disease-free survival (DFS), and distant metastasis-free survival (DMFS) were performed using Kaplan-Meier analysis. Univariate and multivariable logistic regression models were used to identify significant associated factors.
Of 59 patients meeting the criteria for analysis and available for review, 14 ASA users were identified. ASA users demonstrated increased OS ( = 0.03) and DMFS ( = 0.02), with 5-year OS and DMFS of 92% ( = 0.01) and 85% ( = 0.01) compared to 51% and 43%, respectively, for non-ASA users. In univariate analysis, pT stage, pN stage, and ASA use were significantly correlated ( < 0.05) with OS and DFS. On multivariable analysis, ASA use (hazard ratio [HR], 0.11; 95% confidence interval [CI], 0.01-0.8) and lymph node stage (HR, 5.9; 95% CI, 1.4-25.9) remained significant for OS and DFS ASA use (HR, 0.13; 95% CI, 0.03-0.56) and lymph node stage (HR, 5.6; 95% CI, 1.9-16.4).
ASA use during remission was associated with significantly improved OS and DMFS in patients with IBC. These results suggest that ASA may provide survival benefits to patients with IBC. Prospective clinical trials of ASA use in patients with high-risk IBC in remission should be considered.
炎性乳腺癌（IBC）是乳腺癌最具侵袭性的形式，极易发生远处转移。我们之前的数据表明，服用阿司匹林（乙酰水杨酸，ASA）可能与侵袭性乳腺癌远处转移风险降低有关；然而，尚无关于服用ASA对IBC患者潜在益处的报道研究。
回顾了2000年至2017年期间在两家机构接受治疗的非转移性IBC患者的数据。采用Kaplan-Meier分析评估总生存期（OS）、无病生存期（DFS）和无远处转移生存期（DMFS）。使用单变量和多变量逻辑回归模型确定显著相关因素。
在59例符合分析标准且可供审查的患者中，确定了14例服用ASA的患者。服用ASA的患者OS（P = 0.03）和DMFS（P = 0.02）有所增加，5年OS和DMFS分别为92%（P = 0.01）和85%（P = 0.01），而非服用ASA的患者分别为51%和43%。在单变量分析中，pT分期、pN分期和服用ASA与OS和DFS显著相关（P < 0.05）。在多变量分析中，服用ASA（风险比[HR]，0.11；95%置信区间[CI]，0.01 - 0.8）和淋巴结分期（HR，5.9；95% CI，1.4 - 25.9）对OS和DFS仍具有显著意义，服用ASA（HR，0.13；95% CI，0.03 - 0.56）和淋巴结分期（HR，5.6；95% CI，1.9 - 16.4）。
缓解期服用ASA与IBC患者的OS和DMFS显著改善相关。这些结果表明，ASA可能为IBC患者带来生存益处。应考虑对缓解期高危IBC患者使用ASA进行前瞻性临床试验。
