Chen Po-Huang, Yang Tung-Lung, Jhou Hong-Jie, Lee Hsu-Lin, Dai Ming-Shen
Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Department of Neurology, Changhua Christian Hospital, Changhua 500, Taiwan.
Diagnostics (Basel). 2024 Dec 27;15(1):44. doi: 10.3390/diagnostics15010044.
: Breast cancer is a leading cause of cancer-related mortality in women. Aspirin, an affordable anti-inflammatory drug, may have anticancer effects, but its impact on survival outcomes after breast cancer diagnosis remains unclear. This meta-analysis evaluates the role of post-diagnostic aspirin use in breast cancer management. : A systematic review and meta-analysis were conducted using PubMed, EMBASE, and Cochrane Library databases. Twenty studies involving 141,251 participants were included. Survival outcomes assessed were disease-free survival (DFS), overall survival (OS), and breast cancer-specific mortality. Trial sequential analysis (TSA) was used to evaluate the sufficiency of cumulative evidence. : Post-diagnostic aspirin use was not significantly associated with DFS (HR: 0.88; 95% CI: 0.69-1.11) or OS (HR: 0.89; 95% CI: 0.74-1.07). However, a significant reduction in breast cancer-specific mortality was observed (HR: 0.77; 95% CI: 0.63-0.93). TSA confirmed that the evidence supporting this association is sufficient. : Post-diagnostic aspirin use significantly reduces breast cancer-specific mortality, but it does not improve DFS or OS. These findings underscore the potential therapeutic role of aspirin in breast cancer management. Further randomized controlled trials are needed to validate these results and determine optimal dosing regimens for post-diagnostic use.
乳腺癌是女性癌症相关死亡的主要原因。阿司匹林是一种价格低廉的抗炎药物，可能具有抗癌作用，但其对乳腺癌诊断后生存结果的影响仍不明确。本荟萃分析评估了诊断后使用阿司匹林在乳腺癌治疗中的作用。
使用PubMed、EMBASE和Cochrane图书馆数据库进行了系统评价和荟萃分析。纳入了20项研究，涉及141251名参与者。评估的生存结果包括无病生存期（DFS）、总生存期（OS）和乳腺癌特异性死亡率。采用试验序贯分析（TSA）来评估累积证据的充分性。
诊断后使用阿司匹林与DFS（风险比：0.88；95%置信区间：0.69 - 1.11）或OS（风险比：0.89；95%置信区间：0.74 - 1.07）无显著关联。然而，观察到乳腺癌特异性死亡率显著降低（风险比：0.77；95%置信区间：0.63 - 0.93）。TSA证实支持这种关联的证据是充分的。
诊断后使用阿司匹林可显著降低乳腺癌特异性死亡率，但不能改善DFS或OS。这些发现强调了阿司匹林在乳腺癌治疗中的潜在治疗作用。需要进一步的随机对照试验来验证这些结果，并确定诊断后使用的最佳给药方案。
