Low-dose aspirin use and survival in breast cancer patients: A nationwide cohort study

TLDR: Little evidence of an association between post-diagnostic low-dose aspirin use and cancer-specific mortality is found in this large nationwide study of breast cancer patients.

About: This article is published in Cancer Epidemiology.The article was published on 2017-04-01 and is currently open access. It has received 17 citations till now. The article focuses on the topics: Breast cancer & Cancer registry.

Figures

Table 1. Characteristics of breast cancer patients by post-diagnostic low-dose aspirin use

Table 3. Association between low-dose aspirin use before diagnosis and cancer-specific and all-cause mortality in patients with breast cancer.

Table 2. Association between low-dose aspirin use after diagnosis and cancer-specific and all-cause mortality in patients with breast cancer.

Frequently asked questions

Q1. What are the contributions in "Low-dose aspirin use and survival in breast cancer patients: a nationwide cohort study" ?

In this paper, the authors investigated whether post-diagnostic low-dose aspirin use was associated with a decreased risk of death from breast cancer in a large nation-wide cohort of breast cancer patients diagnosed in Scotland. 

Q2. What is the reason for the extended breast cancer survival observed for aspirin users?

It is possible that the extended breast cancer survival observed for aspirin users in these studies may be due to higher PTSG-2 inhibiting doses as opposed to doses which inhibit platelet function. 

Q3. What is the effect of low-dose aspirin on breast cancer?

In a large breast cancer patient cohort, the authors investigated whether post-diagnostic low-dose aspirin use was associated with a reduction in the risk of breast cancer-specific mortality. 

Q4. What is the effect of aspirin on breast cancer?

In a further study of 935 breast cancer patients enrolled in the Carolina Breast Cancer Study, increased duration and regularity of self-reported pre-diagnostic NSAID use (including aspirin) was associated with reduced breast cancer-specific mortality in women with ERpositive tumours while no association was seen for women with ER-negative tumours [34]. 

Q5. What data was used to identify deaths from breast cancer?

Deaths were identified from National Records of Scotland with coverage up to 1st January 2015 (or from Scottish Cancer Registry death records) with breast cancer-specific deaths defined as those with breast cancer as the underlying cause of death (ICD code C50). 

Q6. What was the effect of low-dose aspirin use on breast cancer?

Cox regression models were used to calculate hazard ratios (HR) and 95% CIs for breast cancer-specific and all-cause mortality by post-diagnostic low-dose aspirin use. 

Q7. how was the association between low-dose aspirin use and mortality?

post-diagnostic low-dose aspirin use was associated with an increase in all-cause mortality (HR 2.18, 95% CI 1.99, 2.40) which weakened in adjusted analysis but remained statistically significant (adjusted HR 1.21 1.04, 1.40). 

Q8. What is the main reason for the misclassification of aspirin use?

Misclassification of drug use is possible as over-the-counter use of low-dose aspirin was not accounted for, although previous evidence suggests that the majority of chronic aspirin use in administrative prescribing databases is captured [37].