title: The Role of Non-Steroidal Anti-Inflammatory Drugs in the Chemoprevention of Breast Cancer.
abstract: Epidemiological evidence suggests that non-steroidal anti-inflammatory drugs (NSAIDs) which act as cyclooxygenase (COX-2) inhibitors may reduce breast cancer incidence by up to 20%. These agents are often taken for pain relief by older women with osteoarthritis. Age is the major risk factor for breast cancer in women with 50% cases being diagnosed in those aged >65 years. NSAIDs reduce serum estradiol by 17% in post-menopausal women and since most of these who develop breast cancers have estrogen receptor positive tumours; this suggests a possible preventative role. Careful use of these agents could provide a strategy for both relief of symptoms of osteoarthritis and also breast cancer prevention. Instead of conducting a randomised trial, proof of efficacy could be from an adequately powered cohort study within the breast screening programme.
authors.affiliation: Hedley Atkins Breast Unit, Guy's Hospital, London SE1 9RT, UK. raheresarah@btinternet.com.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Horn
authors.affiliation: Hedley Atkins Breast Unit, Guy's Hospital, London SE1 9RT, UK. ian.fentiman@gstt.nhs.uk.
authors.forename: Ian S
authors.initials: IS
authors.lastname: Fentiman
keywords: breast cancer; chemoprevention; non-steroidal anti-inflammatory drugs