Does Aspirin Prevent Breast Cancer Recurrence? Maybe.

Patient Expert

An apple a day may keep the doctor away for most people, but for breast cancer survivors it may be a daily aspirin that does the trick.

A study published Feb. 16, 2010 in the Journal of Clinical Oncology's online edition summed up the findings of a 30-year study by doctors and researchers at Boston's Brigham and Women's Hospital, Dana-Farber Cancer Institute, and Harvard, as follows:

"Among women living at least 1 year after a breast cancer diagnosis, aspirin use was associated with a decreased risk of distant recurrence and breast cancer death."

That stark statement of fact was headlined in major media outlets all over the country, including USA Today, the LA Times, Boston Globe, Washington Post, and ABC News, among others.

Aspirin prevents breast cancer recurrence? Big news, indeed. But before you start popping a daily Bayer along with your calcium and vitamin D, let's analyze the back story.

Study results came from the ongoing Nurses' Health Study, which has been examining various health factors affecting thousands of nurses in the Boston area for decades. And here's what it found, specifically: of the 4,164 breast cancer survivors in the study, those who took aspirin 2 to 5 days a week had a 60 percent reduced risk of metastasis, and a 71 percent lower risk of death from breast cancer.

Interestingly, taking aspirin more frequently (6-7 days a week) showed decreased benefit, as did taking aspirin 1 or fewer days a week.

Though the dosage wasn't tracked, it was assumed to be 81mg, the typical low maintenance dose taken for heart health: the equivalent of a baby aspirin.

Scientists are theorizing that aspirin's anti-inflammatory benefits somehow disable cancer cells. They've also observed that aspirin stops the growth of breast cancer tumor cells, at least in a scientific setting.

So why shouldn't you immediately start taking a baby aspirin Monday through Friday?

Two reasons.

First, the study results are what's called "observational," which means it shows a relationship, but can't prove it. "Where there's smoke, there's fire" isn't ALWAYS true. Study author Michelle Holmes, of the Harvard School of Public Health, cautioned that more research is needed to confirm the findings before aspirin use to prevent breast cancer recurrence becomes widespread.

Second, aspirin, even in low doses, can cause other health problems when taken over a long period of time. Scientist Eric Jacobs, writing on the American Cancer Society's Web site, noted that "It would be premature for breast cancer survivors to use aspirin in order to reduce risk of breast cancer recurrence or of dying from their disease. Cancer survivors, as well as other adults, should discuss the risks and benefits of aspirin use with their doctor. Aspirin use can cause adverse effects, including serious gastrointestinal bleeding."

So what's our bottom line here?

Given that for stage 1, 2, or 3 breast cancer survivors with no known metastasis, the study indicates that a low-dose aspirin, 2 to 5 days a week, can cut the risk of recurrence by 60%, and the risk of breast cancer death by 71%, here's what I think:

-If you're in active treatment (surgery, chemo, radiation), don't self-medicate with aspirin; it can interfere with your other treatments.
-If you're on long-term hormone therapy; or past all cancer treatment, ask your doctor about the risks and benefits of aspirin in general.
-If your doctor feels you're at minimal risk for adverse side effects from aspirin; and you understand those risks yourself, and accept them - then you might consider a low dose.

As Dr. Holmes said yesterday, ""taking aspirin may become another simple, low-cost and relatively safe tool to help women with breast cancer live longer, healthier lives."

A "longer, healthier" life?

I can live with that.