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Non-steroidal anti-inflammatory drugs (NSAIDs) and breast cancer risk: differences by molecular subtype
Theodore M Brasky1, Matthew R Bonner, Kirsten B Moysich
1Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA. tbrasky@fhcrc.org
Abstract:
Use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced risk of breast cancer, though findings have been inconsistent. This inconsistency may result from differences in etiology for breast tumors of different subtypes. We examined the association between NSAID use and breast cancer characterized by molecular subtypes in a population-based case-control study in Western New York. Cases (n = 1,170) were women with incident, primary, histologically confirmed breast cancer. Controls (n = 2,115) were randomly selected from NY Department of Motor Vehicles records (<65 years) or Medicare rolls (≥ 65 years). Participants answered questions regarding their use of aspirin and ibuprofen in the year prior to interview and their use of aspirin throughout their adult life. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (95% CI). Recent and lifetime aspirin use was associated with reduced risk, with no differences by subtype. Recent use of ibuprofen was significantly associated with increased risk of ER+/PR+(OR 1.33, 95% CI: 1.09-1.62), HER2- (OR 1.27, 95% CI: 1.05-1.53), and p53- breast cancers (OR 1.28, 95% CI: 1.04-1.57), as well as luminal A or B breast cancers. These findings support the hypothesis of heterogeneous etiologies of breast cancer subtypes and that aspirin and ibuprofen vary in their effects.
Insights
Aspirin use may lower breast cancer risk, but ibuprofen use appears to increase risk for certain subtypes. This highlights how different non-steroidal anti-inflammatory drugs (NSAIDs) affect breast cancer risk differently.
Area of Science:
- Oncology
- Epidemiology
- Pharmacology
Background:
- Non-steroidal anti-inflammatory drug (NSAID) use has shown inconsistent associations with breast cancer risk.
- Breast cancer heterogeneity, defined by molecular subtypes, may explain these inconsistencies.
- Understanding NSAID effects across different breast cancer subtypes is crucial for risk assessment.
Purpose of the Study:
- To investigate the association between aspirin and ibuprofen use and breast cancer risk across molecular subtypes.
- To explore whether NSAID effects on breast cancer risk differ by tumor characteristics.
- To provide insights into the heterogeneous etiologies of breast cancer.
Main Methods:
- Population-based case-control study in Western New York.
- Inclusion of 1,170 primary breast cancer cases and 2,115 controls.
- Logistic regression analysis of recent and lifetime NSAID use (aspirin, ibuprofen).
Main Results:
- Recent and lifetime aspirin use was associated with reduced breast cancer risk, irrespective of subtype.
- Recent ibuprofen use was linked to an increased risk of estrogen receptor-positive/progesterone receptor-positive (ER+/PR+), HER2-negative (HER2-), and p53-positive breast cancers.
- Ibuprofen use was also associated with increased risk for Luminal A and B breast cancer subtypes.
Conclusions:
- Findings support the hypothesis that breast cancer subtypes have distinct etiologies.
- Aspirin and ibuprofen demonstrate differential effects on breast cancer risk.
- Further research is warranted to elucidate the mechanisms behind these varied NSAID effects.
