Pre-diagnostic aspirin use and mortality after breast cancer
Menée aux Etats-Unis à partir de données portant sur 1 442 patientes atteintes d'un cancer primitif du sein, cette étude de cohorte évalue l'association entre une utilisation d'aspirine avant le diagnostic, l'indice de masse corporelle et la mortalité spécifique
Background : Whether aspirin or other nonsteroidal anti-inflammation drug (NSAID) use is associated with mortality following breast cancer remains unclear. Consideration of use patterns and interaction with obesity may help to clarify the inconsistent results. Methods : Pre-diagnosis NSAID use, weight, and height were assessed ~ 3 months after diagnosis through in-person interviews with a population-based cohort of 1,442 women with first primary breast cancer. Vital status was determined through the national death index after ~ 18 years of follow-up (N = 237/597 breast cancer-specific/all-cause deaths). We used Cox proportional hazards regression to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Multiplicative interaction by body mass index (BMI) was evaluated using the likelihood ratio test. Results : Ever aspirin use was inversely associated with breast cancer-specific mortality (HR 0.87, 95% CI 0.59–1.29), but positively associated with all-cause mortality (HR 1.21, 95% CI 0.99–1.48); the CIs included the null values. The HRs, however, were more pronounced for the highest level of duration, frequency, regularity, and timing for all-cause, but not breast cancer-specific mortality. Interactions with BMI revealed no significant heterogeneity (pinteraction = 0.37 and pinteraction = 0.36, respectively). Conclusion : Pre-diagnosis aspirin use was not strongly associated with mortality following breast cancer. The all-cause mortality associations, however, were slightly stronger when we considered patterns of use.