title: Personalizing Aspirin Use for Targeted Breast Cancer Chemoprevention in Postmenopausal Women.
abstract: OBJECTIVE
  To evaluate the association of aspirin and other nonsteroidal anti-inflammatory drugs with the incidence of postmenopausal breast cancer for risk subgroups defined by selected nonmodifiable or difficult to modify breast cancer risk factors in order to better understand the potential risk-benefit ratio for targeted chemoprevention.
  
  
  METHODS
  Postmenopausal women with no history of cancer on July 1, 1992 (N=26,580), were prospectively followed up through December 31, 2005, for breast cancer incidence (N=1581). Risk subgroups were defined on the basis of family history of breast cancer, age at menarche, age at menopause, parity/age at first live birth, personal history of benign breast disease, and body mass index. Hazard ratios (HRs) and 95% CIs adjusted for other breast cancer risk factors were estimated using Cox models.
  
  
  RESULTS
  Aspirin use was associated with a lower incidence of breast cancer for women with a family history of breast cancer (HR, 0.62 for 6 or more times per week vs never use; 95% CI, 0.41-0.93) and those with a personal history of benign breast disease (HR, 0.69; 95% CI, 0.50-0.95) but not for women in higher-risk subgroups for age at menarche, age at menopause, parity/age at first live birth, or body mass index. In contrast, inverse associations with aspirin use were observed in all lower-risk subgroups. Nonsteroidal anti-inflammatory drug use had no association with breast cancer incidence.
  
  
  CONCLUSIONS
  On the basis of their increased risk of breast cancer, postmenopausal women with a family history of breast cancer or a personal history of benign breast disease could potentially be targeted for aspirin chemoprevention studies. Future studies are needed to confirm these findings.
authors.affiliation: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA.
authors.forename: Aditya
authors.initials: A
authors.lastname: Bardia
authors.affiliation: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA.
authors.forename: Tanya E
authors.initials: TE
authors.lastname: Keenan
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Jon O
authors.initials: JO
authors.lastname: Ebbert
authors.affiliation: School of Public Health, University of Minnesota, Minneapolis.
authors.forename: DeAnn
authors.initials: D
authors.lastname: Lazovich
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Alice H
authors.initials: AH
authors.lastname: Wang
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Vierkant
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Olson
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Celine M
authors.initials: CM
authors.lastname: Vachon
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Limburg
authors.affiliation: School of Public Health, University of Minnesota, Minneapolis.
authors.forename: Kristin E
authors.initials: KE
authors.lastname: Anderson
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN. Electronic address: cerhan.james@mayo.edu.
authors.forename: James R
authors.initials: JR
authors.lastname: Cerhan
mesh_terms: D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D018890:Chemoprevention / Q000379:methods / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017698:Postmenopause; D016016:Proportional Hazards Models; D017584:Reproductive History; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin