Regular aspirin use, breast tumor characteristics and long-term breast cancer survival

Cheng Peng; Tengteng Wang; Michelle D Holmes; Wendy Y Chen; Kristen D Brantley; Phuong Anh Le; Yujing J Heng; Pepper J Schedin; Bernard A Rosner; Walter C Willett; Meir J Stampfer; Rulla M Tamimi; A Heather Eliassen

doi:10.1038/s41523-025-00775-2

Regular aspirin use, breast tumor characteristics and long-term breast cancer survival

NPJ Breast Cancer. 2025 Jul 1;11(1):62. doi: 10.1038/s41523-025-00775-2.

Authors

Cheng Peng¹, Tengteng Wang², Michelle D Holmes³, Wendy Y Chen⁴, Kristen D Brantley^{3

5}, Phuong Anh Le⁵, Yujing J Heng⁶, Pepper J Schedin⁷, Bernard A Rosner^{3

8}, Walter C Willett^{3

5

9}, Meir J Stampfer^{3

5

9}, Rulla M Tamimi¹⁰, A Heather Eliassen^{3

5

9}

Affiliations

¹ Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA. recpe@channing.harvard.edu.
² Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
³ Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
⁴ Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
⁵ Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
⁶ Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁷ Department of Cell, Developmental and Cancer Biology, Oregon Health and Science University, Portland, OR, USA.
⁸ Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
⁹ Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
¹⁰ Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.

Abstract

Epidemiologic data, supported by experiments, suggest aspirin may improve survival in breast cancer patients. However, recent trials reported a lack of protection, though the length of intervention was limited. Among 10,705 stages I-III breast cancer patients in the Nurses' Health Studies (NHS/NHSII), we examined the associations between post-diagnostic aspirin use and long-term breast cancer survival. During up to 34 years of follow-up, regular post-diagnostic aspirin use was associated with a 38% and 28% lower risk of breast cancer-specific and total mortality. Associations were more evident with longer duration of post-diagnostic aspirin use but attenuated with higher stage and older age at diagnosis. Pre-diagnostic long-term aspirin use was associated with the downregulation of tumor proliferation pathways in NHS/NHSII and the aspirin-gene-expression-signature predicted better survival in METABRIC. Our study highlighted the need for trials with longer duration and suggested that aspirin use before diagnosis may alter the tumor-microenvironment towards a less proliferative type.

Abstract

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