Peng Cheng, Wang Tengteng, Holmes Michelle D, Chen Wendy Y, Brantley Kristen D, Le Phuong Anh, J Heng Yujing, Schedin Pepper J, Rosner Bernard A, Willett Walter C, Stampfer Meir J, Tamimi Rulla M, Heather Eliassen A
Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
NPJ Breast Cancer. 2025 Jul 1;11(1):62. doi: 10.1038/s41523-025-00775-2.
Epidemiologic data, supported by experiments, suggest aspirin may improve survival in breast cancer patients. However, recent trials reported a lack of protection, though the length of intervention was limited. Among 10,705 stages I-III breast cancer patients in the Nurses' Health Studies (NHS/NHSII), we examined the associations between post-diagnostic aspirin use and long-term breast cancer survival. During up to 34 years of follow-up, regular post-diagnostic aspirin use was associated with a 38% and 28% lower risk of breast cancer-specific and total mortality. Associations were more evident with longer duration of post-diagnostic aspirin use but attenuated with higher stage and older age at diagnosis. Pre-diagnostic long-term aspirin use was associated with the downregulation of tumor proliferation pathways in NHS/NHSII and the aspirin-gene-expression-signature predicted better survival in METABRIC. Our study highlighted the need for trials with longer duration and suggested that aspirin use before diagnosis may alter the tumor-microenvironment towards a less proliferative type.
实验支持的流行病学数据表明，阿司匹林可能会提高乳腺癌患者的生存率。然而，近期试验报告称缺乏保护作用，尽管干预时间有限。在护士健康研究（NHS/NHSII）的10705例I - III期乳腺癌患者中，我们研究了诊断后使用阿司匹林与乳腺癌长期生存之间的关联。在长达34年的随访期间，诊断后定期使用阿司匹林与乳腺癌特异性死亡率和总死亡率分别降低38%和28%相关。诊断后使用阿司匹林的时间越长，关联越明显，但随着诊断时分期越高和年龄越大，关联减弱。诊断前长期使用阿司匹林与NHS/NHSII中肿瘤增殖途径的下调相关，并且阿司匹林基因表达特征预测在METABRIC中生存更好。我们的研究强调了进行更长时间试验的必要性，并表明诊断前使用阿司匹林可能会使肿瘤微环境向增殖性较低的类型转变。
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