Aspirin is a known anti-inflammatory agent, but few studies have investigated its use among African American women to reduce the risk of breast cancer.
Aspirin as a chemopreventive medication in breast cancer was recently studied among African American women, and the study results show its potential for use among these patients who have estrogen receptor (ER)-negative or triple-negative disease, according to an article published in Breast Cancer Research.
“Few studies have investigated these associations among African American women,” the authors noted, “nor have any previous studies in African American women evaluated whether associations differ by ER subtype.”
The investigators gathered data from the Black Women’s Health Study, an ongoing nationwide cohort study, to conduct a prospective analysis of 53,126 African American women who answered questionnaires regarding their aspirin use and duration of use (<1, 1, 2, 3-4, or >5 years), at baseline in 1995 and follow-up. All of the women were aged 21 to 69 years, and the follow-up questionnaires were sent every 2 years.
For the purposes of this study, regular aspirin use was defined as “use at least 3 days per week.”
Over 22 years of follow-up (1995-2017), there were 1919 diagnoses of invasive breast cancer, and ER status was available for 1681 (88%):
Compared with nonuse of aspirin, results show that its regular use was associated with an 8% overall lower risk of breast cancer (HR, 0.92; 95% CI, 0.81-1.04). Although this risk remained relatively unchanged for women with ER-positive disease (HR, 0.98; 95% CI, 0.84-1.15), regular aspirin use was associated with a noticeable 19% decline in risk of disease among those with ER-negative breast cancer (HR, 0.81; 95% CI, 0.64-1.04) and 30% for those with TNBC (HR, 0.70; 95% CI, 0.49-0.99).
Analyses also revealed:
The authors believe that their results require confirmation in studies that have larger populations of African American women. Limitations to their findings include that the data were self-reported, information on aspirin dose was not available, and they did not evaluate nonaspirin NSAIDs separately. Study strengths include its 20-plus years of follow-up and the detailed characterization of breast cancer risk factors.
“The results of this study support the hypothesis that regular aspirin use is associated with reduced breast cancer risk, particularly for ER[-negative] and TN breast cancer, in African American women,” the investigators concluded. “If findings from this study are confirmed, aspirin may represent a potential opportunity for chemoprevention of ER[-negative] and TN breast cancer.”
Bertrand KA, Bethea TN, Gerlovin H, et al. Aspirin use and risk of breast cancer in African American women. Breast Cancer Res. Published online September 4, 2020. doi:10.1186/s13058-020-01335-1