TY - JOUR
T1 - Association between low-dose aspirin use and breast cancer recurrence
T2 - a Danish nationwide cohort study with up to 23 years of follow-up
AU - Solmunde, Elisabeth
AU - Pedersen, Rikke N.
AU - Nørgaard, Mette
AU - Mellemkjær, Lene
AU - Friis, Søren
AU - Ejlertsen, Bent
AU - Ahern, Thomas P.
AU - Cronin-Fenton, Deirdre P.
PY - 2025/10/5
Y1 - 2025/10/5
N2 - Background: The anti-cancer potential of low-dose aspirin in long-term breast cancer (BC) survivors remain unknown. We evaluated the association between low-dose aspirin use and BC recurrence and mortality. Methods: Women ≥40 years diagnosed with stage I-III BC (1996–2004) were identified from the Danish Breast Cancer Group (DBCG) database and information on aspirin use from the Danish Prescription Registry. We ascertained recurrences from DBCG and via a validated algorithm. We plotted cumulative incidences of recurrence and mortality, accounting for competing risks. Using Cox regression, we estimated hazard ratios (HRs) and 95% confidence intervals (CI), employing landmark analyses at 5-, 10-, and 15-year post-diagnosis. Results: Among 20,509 BC survivors, 4527 developed recurrence over 232,441 person-years of follow-up. The 20-year cumulative incidence of recurrence was lower in users (17.8%) than nonusers (22.4%), with similar trends among 10-year disease-free survivors (9.9% vs. 12.7%). We observed reduced HRs of recurrence (adjusted HR5-year = 0.80, (95% CI = 0.66-0.98); HR10-year = 0.87 (0.73–1.05); HR15-year = 0.82 (0.57–1.17) in aspirin users, but increased HRs of all-cause mortality (HR5-year = 1.08 (0.96–1.21); HR10-year = 1.09 (0.96–1.24); HR15-year = 1.09 (0.80–1.31). Conclusions: The reduced recurrence risk in aspirin users may indicate potential anti-cancer effects of aspirin, though the increased risk of death suggests influence by confounding by indication and competing risks.
AB - Background: The anti-cancer potential of low-dose aspirin in long-term breast cancer (BC) survivors remain unknown. We evaluated the association between low-dose aspirin use and BC recurrence and mortality. Methods: Women ≥40 years diagnosed with stage I-III BC (1996–2004) were identified from the Danish Breast Cancer Group (DBCG) database and information on aspirin use from the Danish Prescription Registry. We ascertained recurrences from DBCG and via a validated algorithm. We plotted cumulative incidences of recurrence and mortality, accounting for competing risks. Using Cox regression, we estimated hazard ratios (HRs) and 95% confidence intervals (CI), employing landmark analyses at 5-, 10-, and 15-year post-diagnosis. Results: Among 20,509 BC survivors, 4527 developed recurrence over 232,441 person-years of follow-up. The 20-year cumulative incidence of recurrence was lower in users (17.8%) than nonusers (22.4%), with similar trends among 10-year disease-free survivors (9.9% vs. 12.7%). We observed reduced HRs of recurrence (adjusted HR5-year = 0.80, (95% CI = 0.66-0.98); HR10-year = 0.87 (0.73–1.05); HR15-year = 0.82 (0.57–1.17) in aspirin users, but increased HRs of all-cause mortality (HR5-year = 1.08 (0.96–1.21); HR10-year = 1.09 (0.96–1.24); HR15-year = 1.09 (0.80–1.31). Conclusions: The reduced recurrence risk in aspirin users may indicate potential anti-cancer effects of aspirin, though the increased risk of death suggests influence by confounding by indication and competing risks.
UR - https://www.scopus.com/pages/publications/105011178171
U2 - 10.1038/s41416-025-03112-3
DO - 10.1038/s41416-025-03112-3
M3 - Journal article
C2 - 40691279
AN - SCOPUS:105011178171
SN - 0007-0920
VL - 133
SP - 865
EP - 873
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 6
ER -