By Lauren Haines, Pharm.D. student
According to the American Cancer Society, one in eight U.S. women will develop breast cancer in their lifetime.1 Breast cancer involves cancer cells forming a tumor in the breast tissue. Risk factors include: women ages 65 and older, inherited genetic mutations, two or more close relatives diagnosed at an early age, postmenopausal obesity, use of combined estrogen and progestin menopausal hormones, cigarette smoking, alcohol consumption, and women who breastfed for a long time. Currently, breast cancer is treated with surgery, radiation therapy, systemic therapy, chemotherapy, hormone therapy, and targeted therapy. Treatment with surgery is the most common and involves removing cancer from the breast to determine the disease severity. However, other methods may also be used to kill the cancer cells such as chemotherapy and radiation. These methods have many side effects that women must choose to endure to treat their cancer, including increased risk of uterine cancer, pain, hair loss, nausea, vomiting, fatigue, increased risk of infections, and depression.1
A new method researchers are evaluating to help prevent death from breast cancer is the use of aspirin. In a recent article by Michelle Holmes and colleagues, researchers evaluated the relationship between aspirin use and breast cancer survival. Researchers identified women newly diagnosed with breast cancer and then assigned them one of three groups, which were either to not receive any daily dose (75mg to 160mg depending on where it was bought) of aspirin, receive less than one daily dose of aspirin, or receive one or more daily doses of aspirin. Patients were followed throughout the study, for up to five and a half years, to determine if they died from breast cancer. When the women taking at least one daily dose of aspirin were compared to those not taking any aspirin in the last six months of the study, there was about a 4% decreased risk of death from breast cancer in the women taking the aspirin. However, the women taking less than a daily dose compared to those not taking any aspirin had about a 3% increased risk of death from breast cancer. The limitations of this study included that aspirin could be bought over-the-counter, so anybody could buy it without pharmacy record; low dosages were only available through prescriptions; and researchers lacked additional clinical data on breast cancer characteristics and treatment.2
Although using aspirin is still being researched to determine its effect on breast cancer patients, it may be a good option for women aside from standard treatment options. Current methods involve aggressive strategies to destroy breast cancer and prevent future cases, which must be authorized by a doctor or surgeon. Aspirin is available over-the-counter, which would provide easy access for patients who can’t receive other types of treatment. However, aspirin does have side effects of its own that patients should be aware of, including: nausea, vomiting, stomach pain, and heart burn. Aspirin can also cause decreased blood clotting, which may cause increased bleeding. Also, aspirin shouldn’t be used during pregnancy, and it has many drug interactions with blood pressure, water, and blood thinner medications.3
Although the previous article doesn’t provide clear evidence that aspirin decreases death from breast cancer, other articles support its conclusions. In another article, researchers tested the effect of aspirin used with tamoxifen, a prescription drug used to treat breast cancer, to determine if the combination of the medications helped with the treatment. Researchers found that aspirin helped balance blood protein levels when used with tamoxifen, which improved treatment. However, research showed an increased risk of bruising and upset stomach with aspirin and tamoxifen therapy.4 Other research evaluated the use of aspirin while also using beta-blockers and ACE inhibitors, common drugs used to promote breast cancer patient survival.5 Results showed the use of aspirin with these drugs helped promote the survival process versus the use of the drugs without aspirin by increasing survival rate by more than 50%.5 Evidence also showed the use of aspirin greatly reduced the risk of developing breast cancer in women.6 However, the use of ibuprofen (Advil) and acetaminophen (Tylenol) didn’t reduce breast cancer risk like aspirin did. Ibuprofen had a slight reduction in breast cancer risk, but acetaminophen had no relationship with it. Aspirin especially showed a reduction in postmenopausal women.6 Research on the frequency of aspirin use and potential breast cancer diagnosis concluded that women using aspirin more than six times a week had a 23% decreased risk of developing breast cancer and was not associated with altering hormones.7
Thus, aspirin may be an appropriate choice for women with a high risk of developing breast cancer and women who have been diagnosed with it previously. Aspirin doesn’t require a prescription, so patients can easily buy it usually at a lower cost than many prescription medications. However, patients should consult their primary care physicians before taking aspirin to ensure they are not taking other medications that would interact with it, and that aspirin has potential to help them. Patients should also receive additional advice from loved ones to ensure they support their decision to use aspirin. With both a decreased risk in developing breast cancer and an increased promotion of breast cancer survival, aspirin may be a good option for women.
Would you recommend aspirin to a friend diagnosed with breast cancer or who may have a risk of developing breast cancer?
- American Cancer Society- Breast Cancer. http://www.cancer.org/breastcancer/index. Updated 2014. Accessed October 3, 2014.
- Holmes MD, Olsson H, Pawitan Y, et al. Aspirin intake and breast cancer survival – a nation-wide study using prospectively recorded data in sweden. BMC Cancer. 2014;14(1):1150-1165.
- Aspirin. Aspirin: MedlinePlus Drug Information Web site. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682878.html#side-effects. Updated 2014. Accessed October 3, 2014.
- Holmes CE, Jasielec J, Levis JE, Skelly J, Muss HB. Initiation of aspirin therapy modulates angiogenic protein levels in women with breast cancer receiving tamoxifen therapy. CTS: Clinical & Translational Science. 2013;6(5):386-390.
- Holmes MD, Hankinson SE, Feskanich D, Chen WY. Beta blockers and angiotensin-converting enzyme inhibitors’ purported benefit on breast cancer survival may be explained by aspirin use. Breast Cancer Res Treat. 2013;139(2):507-513.
- Chung CT. Association of frequency and duration of aspirin use and hormone receptor status with breast cancer risk. Women’s Oncology Review. 2004;4(4):279-281.
- Bardia A, Olson JE, Vachon CM, et al. Effect of aspirin and other NSAIDs on postmenopausal breast cancer incidence by hormone receptor status: Results from a prospective cohort study. Breast Cancer Res Treat. 2011;126(1):149-155.