Aspirin Reduces Breast Cancer Recurrence in Overweight Women

The recurrence of hormone-related breast cancer was reduced by more than half in overweight and obese women who regularly used nonsteroidal anti-inflammatory drugs (NSAIDs), according to a new study.

Researchers at the University of Texas (UT; Austin, USA) conducted a retrospective review of data from 440 women with invasive, estrogen receptor alpha (ERα)-positive breast cancer and an average body mass index (BMI) of 30 or higher, who were treated between 1987 and 2011. Around 81% of the women took aspirin and the rest took another NSAID; About 42% of the women took statins, and 25% took omega-3 fatty acid.

The researchers found that even after controlling for statins and omega-3 fatty acid use, the results demonstrated a protective effect from aspirins and other NSAIDs. Women with a BMI greater than 30 who had ERα-positive breast cancer had a 52% lower rate of recurrence and a 28-month delay in recurrence if they were taking aspirin or other NSAIDs. In in-vitro experiments, sera from obese patients stimulated greater macrophage cyclooxygenase-2 (COX-2) expression and proinflammatory eicosanoid prostaglandin E2 (PGE2) production.

The researchers also found that sera from the obese patients stimulated greater breast cancer cell ERα activity, proliferation, and migration, compared with sera from normal-weight patients; and that these differences were eliminated or reduced by the addition of an aromatase inhibitor. NSAID, which inhibits COX-2 activity, was associated with reduced breast cancer recurrence in obese and overweight ERα-positive women. The study was published on August 15, 2014, in Cancer Research.

“Our studies suggest that limiting inflammatory signaling may be an effective, less toxic approach to altering the cancer-promoting effects of obesity,” said lead author, Associate Professor of Nutritional Sciences Linda deGraffenried, PhD. “NSAIDs may improve response to hormone therapy, thereby allowing more women to remain on hormone therapy rather than needing to change to chemotherapy and deal with the associated side effects and complications.”

Obesity is associated with a worse breast cancer prognosis and elevated levels of inflammation, including greater COX-2 expression and activity in adipose-infiltrating macrophages. The product of this enzyme, PGE2, stimulates adipose tissue aromatase expression and subsequent estrogen production, which could promote breast cancer progression.

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