Regular aspirin use, breast tumor characteristics and long-term breast cancer survival.

IF 7.6 2区医学 Q1 ONCOLOGY

NPJ Breast Cancer Pub Date : 2025-07-01 DOI:10.1038/s41523-025-00775-2

Cheng Peng, Tengteng Wang, Michelle D Holmes, Wendy Y Chen, Kristen D Brantley, Phuong Anh Le, Yujing J Heng, Pepper J Schedin, Bernard A Rosner, Walter C Willett, Meir J Stampfer, Rulla M Tamimi, A Heather Eliassen

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Abstract

Epidemiologic data, supported by experiments, suggest aspirin may improve survival in breast cancer patients. However, recent trials reported a lack of protection, though the length of intervention was limited. Among 10,705 stages I-III breast cancer patients in the Nurses' Health Studies (NHS/NHSII), we examined the associations between post-diagnostic aspirin use and long-term breast cancer survival. During up to 34 years of follow-up, regular post-diagnostic aspirin use was associated with a 38% and 28% lower risk of breast cancer-specific and total mortality. Associations were more evident with longer duration of post-diagnostic aspirin use but attenuated with higher stage and older age at diagnosis. Pre-diagnostic long-term aspirin use was associated with the downregulation of tumor proliferation pathways in NHS/NHSII and the aspirin-gene-expression-signature predicted better survival in METABRIC. Our study highlighted the need for trials with longer duration and suggested that aspirin use before diagnosis may alter the tumor-microenvironment towards a less proliferative type.

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定期服用阿司匹林，乳腺肿瘤特征和长期乳腺癌生存。

实验支持的流行病学数据表明，阿司匹林可以提高乳腺癌患者的生存率。然而，最近的试验报告缺乏保护，尽管干预的时间是有限的。在护士健康研究（NHS/NHSII）的10,705名I-III期乳腺癌患者中，我们检查了诊断后阿司匹林使用与长期乳腺癌生存之间的关系。在长达34年的随访期间，诊断后定期服用阿司匹林与乳腺癌特异性死亡率和总死亡率降低38%和28%相关。诊断后使用阿司匹林的时间越长，相关性越明显，但随着诊断时分期越高和年龄越大，相关性越弱。在NHS/NHSII中，诊断前长期使用阿司匹林与肿瘤增殖途径的下调有关，而在METABRIC中，阿司匹林基因表达特征预测了更好的生存率。我们的研究强调需要更长时间的试验，并建议在诊断前使用阿司匹林可能会改变肿瘤微环境，使其向增殖能力较低的类型发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

NPJ Breast Cancer Medicine-Pharmacology (medical)

CiteScore

10.10

自引率

1.70%

发文量

122

审稿时长

9 weeks

期刊介绍： npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.