Abstract: Background: The 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).
Methods: In 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.
Results: In 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.
Conclusion: Most NSAIDs, but not aspirin, showed an inverse association against breast cancer; this effect seems to
be restricted to hormone + or HER2+ cancers.
Keywords: Breast cancer, Non-steroidal anti-inflammatory drug, Hormone receptor positive breast cancer, HER2
positive breast cancer, Triple negative breast cancer
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