Use of nonsteroidal anti-inflammatory drugs and reduced breast cancer risk among overweight women

Chronic inflammation is associated with increased risk of multiple cancers, including breast cancer. Adipose tissues produce proinflammatory cytokines, and obesity is a risk factor for postmenopausal breast cancer. We evaluated the association of regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) with breast cancer risk, overall and by body mass index (BMI) and tumor subtypes defined by estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status. We conducted a population-based, case-control study involving 5,078 women aged 25-75 years who were recruited primarily from the Nashville metropolitan area of Tennessee. Multivariate unconditional logistic regression models were used to estimate odds ratios and 95 % confidence intervals for breast cancer risk after adjusting for multiple potential confounding factors. Regular use of any NSAID was associated with significantly reduced breast cancer risk (OR 0.78; 95 % CI 0.69–0.89). This association was observed for regular use of baby aspirin only (OR 0.82, 95 % CI 0.69–0.99), other NSAIDs only (OR 0.81, 95 % CI 0.69–0.95), and both baby aspirin and other NSAIDs (OR 0.52, 95 % CI 0.40–0.69). These significant inverse associations were found among overweight women (BMI ≥25 kg/m2) overall and by subtypes of breast cancer, but not among women with BMI <25 kg/m2 (P for interaction = 0.023). Regular use of NSAIDs was inversely associated with breast cancer risk, particularly among overweight women. Overweight women may benefit more from the protective effects of NSAID use than normal-weight women.