Use of nonsteroidal anti-inflammatory drugs and reduced breast cancer risk among overweight women
- 370 Downloads
Chronic inflammation is associated with increased risk of multiple cancers, including breast cancer. Adipose tissues produce proinflammatory cytokines, and obesity is a risk factor for postmenopausal breast cancer. We evaluated the association of regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) with breast cancer risk, overall and by body mass index (BMI) and tumor subtypes defined by estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status. We conducted a population-based, case-control study involving 5,078 women aged 25-75 years who were recruited primarily from the Nashville metropolitan area of Tennessee. Multivariate unconditional logistic regression models were used to estimate odds ratios and 95 % confidence intervals for breast cancer risk after adjusting for multiple potential confounding factors. Regular use of any NSAID was associated with significantly reduced breast cancer risk (OR 0.78; 95 % CI 0.69–0.89). This association was observed for regular use of baby aspirin only (OR 0.82, 95 % CI 0.69–0.99), other NSAIDs only (OR 0.81, 95 % CI 0.69–0.95), and both baby aspirin and other NSAIDs (OR 0.52, 95 % CI 0.40–0.69). These significant inverse associations were found among overweight women (BMI ≥25 kg/m2) overall and by subtypes of breast cancer, but not among women with BMI <25 kg/m2 (P for interaction = 0.023). Regular use of NSAIDs was inversely associated with breast cancer risk, particularly among overweight women. Overweight women may benefit more from the protective effects of NSAID use than normal-weight women.
KeywordsNSAIDs Obesity Breast cancer Epidemiology
This work was supported by a research grant (R01CA100374) from the US National Cancer Institute. Surveys for this study were conducted by the Biospecimen and Survey Shared Resource, which is supported in part by P30CA68485. The authors would like to thank the study participants and research staff of the Nashville Breast Health Study for their support of this research, as well as Mary Jo Daly, Bethanie Rammer, and Kimberly Kreth for editing and preparing the manuscript. All experiments comply with the current laws of the United States of America.
Conflict of interest
The authors declare no conflicts of interest.
- 17.Morris PG, Zhou XK, Milne GL, Goldstein D, Hawks LC, Dang CT, Modi S, Fornier MN, Hudis CA, Dannenberg AJ (2013) Increased levels of urinary PGE-M, a biomarker of inflammation, occur in association with obesity, aging, and lung metastases in patients with breast cancer. Cancer Prev Res (Phila) 6(5):428–436. doi: 10.1158/1940-6207.CAPR-12-0431 CrossRefGoogle Scholar
- 18.Subbaramaiah K, Morris PG, Zhou XK, Morrow M, Du B, Giri D, Kopelovich L, Hudis CA, Dannenberg AJ (2012) (2012) Increased levels of COX-2 and prostaglandin E2 contribute to elevated aromatase expression in inflamed breast tissue of obese women. Cancer Discov 2(4):356–365. doi: 10.1158/2159-8290.CD-11-0241 PubMedCentralPubMedCrossRefGoogle Scholar
- 20.Gierach GL, Lacey JV Jr, Schatzkin A, Leitzmann MF, Richesson D, Hollenbeck AR, Brinton LA (2008) Nonsteroidal anti-inflammatory drugs and breast cancer risk in the National Institutes of Health-AARP Diet and Health Study. Breast Cancer Res 10(2):R38. doi: 10.1186/bcr2089 PubMedCentralPubMedCrossRefGoogle Scholar
- 22.Bardia A, Olson JE, Vachon CM, Lazovich D, Vierkant RA, Wang AH, Limburg PJ, Anderson KE, Cerhan JR (2011) Effect of aspirin and other NSAIDs on postmenopausal breast cancer incidence by hormone receptor status: results from a prospective cohort study. Breast Cancer Res Treat 126(1):149–155. doi: 10.1007/s10549-010-1074-x PubMedCentralPubMedCrossRefGoogle Scholar
- 25.Marshall SF, Bernstein L, Anton-Culver H, Deapen D, Horn-Ross PL, Mohrenweiser H, Peel D, Pinder R, Purdie DM, Reynolds P, Stram D, West D, Wright WE, Ziogas A, Ross RK (2005) Nonsteroidal anti-inflammatory drug use and breast cancer risk by stage and hormone receptor status. J Natl Cancer Inst 97(11):805–812PubMedCrossRefGoogle Scholar
- 27.Brasky TM, Bonner MR, Moysich KB, Ambrosone CB, Nie J, Tao MH, Edge SB, Kallakury BV, Marian C, Goerlitz DS, Trevisan M, Shields PG, Freudenheim JL (2011) Non-steroidal anti-inflammatory drugs (NSAIDs) and breast cancer risk: differences by molecular subtype. Cancer Causes Control 22(7):965–975. doi: 10.1007/s10552-011-9769-9 PubMedCentralPubMedCrossRefGoogle Scholar
- 30.Harris RE, Chlebowski RT, Jackson RD, Frid DJ, Ascenseo JL, Anderson G, Loar A, Rodabough RJ, White E, McTiernan A, Initiative Women’s Health (2003) Breast cancer and nonsteroidal anti-inflammatory drugs: prospective results from the Women’s Health Initiative. Cancer Res 63(18):6096–6101PubMedGoogle Scholar
- 31.Parise CA, Bauer KR, Brown MM, Caggiano V (2009) Breast cancer subtypes as defined by the estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor2 (HER2) among women with invasive breast cancer in California, 1999-2004. Breast J 15(6):593–602. doi: 10.1111/j.1524-4741.2009.00822.x PubMedCrossRefGoogle Scholar