Abstract
BackgroundThe relationship between non-steroidal anti-inflammatory drug (NSAID) consumption and breast cancer has been repeatedly studied, although the results remain controversial. Most case-control studies reported that NSAID consumption protected against breast cancer, while most cohort studies did not find this effect. Most studies have dealt with NSAIDs as a whole group or with specific drugs, such aspirin, ibuprofen, or others, but not with NSAID subgroups according to the Anatomical Therapeutic Chemical Classification System; moreover, scarce attention has been paid to their effect on different tumor categories (i.e.: ductal/non-ductal, stage at diagnosis or presence of hormonal receptors).MethodsIn this case-control study, we report the NSAID – breast cancer relationship in 1736 breast cancer cases and 1895 healthy controls; results are reported stratifying by the women’s characteristics (i.e.: menopausal status or body mass index category) and by tumor characteristics.ResultsIn our study, NSAID use was associated with a 24 % reduction in breast cancer risk (Odds ratio [OR] = 0.76; 95 % Confidence Interval [CI]: 0.64–0.89), and similar results were found for acetic acid derivatives, propionic acid derivatives and COXIBs, but not for aspirin. Similar results were found in postmenopausal and premenopausal women. NSAID consumption also protected against hormone + or HER2+ cancers, but not against triple negative breast cancers. The COX-2 selectivity showed an inverse association with breast cancer (i.e. OR < 1), except in advanced clinical stage and triple negative cancers.ConclusionMost NSAIDs, but not aspirin, showed an inverse association against breast cancer; this effect seems to be restricted to hormone + or HER2+ cancers.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2692-4) contains supplementary material, which is available to authorized users.
Highlights
The relationship between non-steroidal anti-inflammatory drug (NSAID) consumption and breast cancer has been repeatedly studied, the results remain controversial
Clinical-pathological characteristics of the breast cancers are reported in Table 2; ductal cancer accounts for 85 % of cases; two out of three breast cancers were diagnosed at stage I or II; more than 70 % of cancers were estrogen receptors +, 14 % were HER2 receptors + and only 6 % were triple negative breast cancers
NSAIDs as a global group protected against breast cancer (OR = 0.76; 95 % confidence intervals (CI): 0.64–0.89); a protective effect was found for acetic acid derivatives, propionic acid derivatives and COX-2 inhibitors (COXIBs), but not for aspirin, COXIB results were based on small numbers of exposed cases and controls, hampering further analysis of their effect in specific subgroups of women
Summary
The relationship between non-steroidal anti-inflammatory drug (NSAID) consumption and breast cancer has been repeatedly studied, the results remain controversial. Most case-control studies reported that NSAID consumption protected against breast cancer, while most cohort studies did not find this effect. Consumption of non-steroidal anti-inflammatory drugs (NSAIDs) is expected to be protective for cancer development. Results from epidemiological studies are inconsistent: cohort studies have reported very modest protective effects or no effect at all [3,4,5], while case-control studies have usually reported moderate protective effects [6,7,8]. The most recent meta-analysis reported a 20 % protective effect of NSAID especially aspirin and COX-2 inhibitors against breast cancer, which seems to be restricted to estrogen receptors + (ER+) or progesterone receptors + (PR+) tumors [9]
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