Abstract
Background
Studies suggest regular aspirin use decreases breast cancer (BRCA) risk, with high
doses exerting an “anti-cancer” effect. Despite reports suggesting aspirin’s protective
role in BRCA, no findings on aspirin dose association(s) with treatment outcomes have
been reported, nor have any molecular subtype associations by which aspirin influences
outcomes been elucidated. To interrogate aspirin’s effect and determine which populations
may benefit from its use, we retrospectively explored data from 1227 patients with
BRCA. In this population, 32 used high-dose aspirin (325 mg), 121 used low-dose aspirin
(81 mg), and 1074 used no aspirin before and/or after diagnosis.
Patients and Methods
Several association tests were performed to examine the correlations of clinical variables
and PIK3CA mutations from 45 patients with BRCA who used 81 mg of aspirin daily. Kaplan-Meyer
survival curves and the log-rank test were utilized to compare survival outcome differences
for aspirin dose, usage history, and PIK3CA mutation status. Cox proportional hazards
models were used to compute the multivariate hazard ratio (HR) for death.
Results
Patients who regularly used high-dose aspirin (325 mg) had better survival outcomes
than those who used low-dose aspirin (81 mg) (HR, 0.094; 95% confidence interval [CI],
0.014-0.62; P = .014). Patients who used aspirin post-diagnosis only achieved significant benefits
in overall survival (HR, 0.082; 95% CI, 0.023-0.3; P = 1.39E-04). Also, a subgroup of patients in the low-dose, long-term aspirin group
with a PIK3CA mutation showed a small beneficial effect (HR, 0.37; 95% CI, 0.04-3.25;
P = .37).
Conclusion
High-dose aspirin after diagnosis may confer BRCA treatment benefits. Future studies
should assess the comprehensive mechanism of aspirin for the PIK3CA mutant subgroup
in a large study.
Keywords
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Article Info
Publication History
Published online: May 17, 2019
Accepted:
May 7,
2019
Received in revised form:
April 12,
2019
Received:
January 23,
2019
Identification
Copyright
Published by Elsevier Inc.
