Breast Cancer Research and Treatment

, Volume 149, Issue 2, pp 525–536 | Cite as

Effect of COX-2 inhibitors and other non-steroidal inflammatory drugs on breast cancer risk: a meta-analysis

  • María de PedroEmail author
  • Sara Baeza
  • María-Teresa Escudero
  • Trinidad Dierssen-Sotos
  • Inés Gómez-Acebo
  • Marina Pollán
  • Javier Llorca


Evidence on non-steroidal anti-inflammatory drugs (NSAID) use and breast cancer risk shows a slightly protective effect of these drugs, but previous studies lack randomized clinical trial results and present high heterogeneity in exposure measurement. This systematic review and meta-analysis widens the knowledge about NSAID use and breast cancer risk, updating the information from the last meta-analysis, focusing on evidence on specific effects of COX-2 inhibitors and differential expression patterns of hormonal receptors. A PubMed-database search was conducted to include all entries published with the keywords “BREAST CANCER NSAID ANTI-INFLAMMATORY” until 10/24/2013 providing original results from cohort studies, case–control studies, or randomized clinical trials with at least one reported relative risk (RR) or odds ratio (OR) on the association between any NSAID use and incidence of invasive breast cancer. This resulted in 49 publications, from which the information was retrieved about type of study, exposure characteristics, breast cancer characteristics, and breast cancer-NSAID association. Meta-analyses were performed separately for case–control and cohort studies and for different hormone-receptor status. NSAID use reduced invasive breast cancer risk by about 20 %. A similar effect was found for aspirin, acetaminophen, COX-2 inhibitors and, to a lesser extent, ibuprofen. The effect of aspirin was similar in preventing hormone-receptor-positive breast cancer. This meta-analysis suggests a slightly protective effect of NSAIDs-especially aspirin and COX-2 inhibitors- against breast cancer, which seems to be restricted to ER/PR+tumors.


Anti-inflammatory drugs NSAID Aspirin Ibuprofen COX-2 inhibitor Breast cancer 


Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • María de Pedro
    • 1
    • 6
    Email author
  • Sara Baeza
    • 2
  • María-Teresa Escudero
    • 3
  • Trinidad Dierssen-Sotos
    • 4
  • Inés Gómez-Acebo
    • 4
  • Marina Pollán
    • 5
  • Javier Llorca
    • 4
  1. 1.Department of Obstetrics and GynecologyNuevo Belén University HospitalMadridSpain
  2. 2.Department of Obstetrics and GynecologyHospital Nuestra Señora de SonsolesÁvilaSpain
  3. 3.Department of Obstetrics and GynecologyMarqués de Valdecilla University HospitalSantanderSpain
  4. 4.Department of Preventive MedicineUniversity of Cantabria Medical School – IDIVAL, and CIBER Epidemiologia y Salud Publica (CIBERESP)SantanderSpain
  5. 5.Unit of Cancer EpidemiologyNational Center of Epidemiology (Institute of Health Carlos III) and CIBER Epidemiologia y Salud Publica (CIBERESP)MadridSpain
  6. 6.Facultad de Medicina (Medicina Preventiva)SantanderSpain

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