Aspirin May Reduce Breast Cancer Death Risk, Study Says

[Guest guest]

Doctors Say Better-Controlled Research Needed

By JOSEPH BROWNSTEIN and JOANNA SCHAFFHAUSEN

ABC News Medical Unit

Feb. 16, 2010

A provocative new study suggests that aspirin reduces the odds of death in

breast cancer survivors, although doctors caution it is too soon to know if

women should start taking the drug as soon as they are diagnosed.

Presurgery MRI exams don't provide the benefits many doctors expected.

The research, part of the long-running Nurses' Health Study, followed 4,164

female nurses who had been diagnosed with early-stage breast cancer. Harvard

investigators found that nurses who took aspirin -- usually to protect

against heart disease -- were 50 percent less likely to have their cancer

spread and 50 percent less likely to die from breast cancer.

" This is a very interesting and exciting study that suggests aspirin may

reduce the recurrence of breast cancer, " said Dr. Besser, senior

health and medical editor for ABC News. " However, the design of the study

does not allow for definitive conclusions. Hopefully, there will be

randomized trials of aspirin use to answer this question. "

The study appears in the latest issue of the Journal of Clinical Oncology.

The risk in drawing too heavily on the current study is that women who were

taking aspirin were doing so of their own volition and were not assigned

randomly to take it by researchers. Therefore, it is possible that the women

taking aspirin had something else in common that would account for their

lower breast cancer mortality.

" We can't prove [at this point] that aspirin improves survival in women with

breast cancer, " said Dr. Holmes, the study's lead author. " You

shouldn't just start taking aspirin because of this for sure. " But, she

said, " If you're taking it for other reasons, you might be helping yourself

in this way too. "

A randomized controlled trial will be necessary for doctors to know if it

was the aspirin itself that accounted for the difference.

" As noted by the study authors, it is possible that survival results could

have been influenced by women with recurrent breast cancer being advised to

stop taking aspirin during chemotherapy, resulting in an overestimate of any

benefit of aspirin use, " said s, strategic director of

pharmacoepidemiology for the American Cancer Society.

" The study also suggested regular aspirin use might reduce risk of breast

cancer recurrence. However, the date of breast cancer recurrence sometimes

needed to be estimated rather than being known, and it is unclear how this

might have influenced results, " he said.

Researchers speculate that aspirin reduces inflammation and thus cuts cancer

risk. Supporting this idea, women who regularly took other anti-inflammatory

drugs, such as ibuprofen, also had a 50 percent lower risk for death from

breast cancer.

Experts say the findings are intriguing and deserve further research. " An

important report ‹ definitely, " said Alan Kristal, an epidemiologist at the

Fred Hutchinson Cancer Research Center in Seattle.

Adding some caution to the findings is that conclusions from the Nurses'

Health Study have been famously wrong on a number of occasions.

Data from this study showed women who took hormone replacement therapy had

lower rates of heart disease -- a finding that was not confirmed in a

randomized study. Similarly, it showed that women who took vitamin E had

lower rates of heart disease. Later research found this not to be true;

vitamin E might even be harmful in large doses.

" The vitamin E story needs to humble us here, " said Dr. Tim Byers, deputy

director of the University of Colorado Cancer Center in Denver. " This is

especially important as so many breast cancer survivors will be jumping at

this... This will inevitably be a news story. Covering it with the right

amount of uncertainty will be important. "

Others agree that it could be dangerous if women started taking aspirin

because of these findings. " Because frequent aspirin use can have serious

side effects such as (occasionally fatal) gastrointestinal bleeding, it's

not something I would want to encourage based on this study alone, " said

Sander Greenland, an epidemiologist at UCLA.

But while it may be too soon to take aspirin for breast cancer, there could

be other reasons to take it.

" There are many women with heart disease for whom aspirin is recommended, "

said Besser. " It is worth speaking with your doctor to find out if you fall

into that group.