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September 22/29, 2004

Association of Aspirin Use and Hormone Receptor Status With Breast Cancer Risk

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(12):1426-1427. doi:10.1001/jama.292.12.1426-a

To the Editor: The recent article by Dr Terry and colleagues1 provides important data on the chemopreventive effects of aspirin and breast cancer risk. It is likely that the preventive effect of nonsteroidal anti-inflammatory drugs (NSAIDs) is actually stronger than reported in this article. The analysis derived from the Long Island Breast Cancer Study Project was based only on reported use of aspirin, ibuprofen, or acetaminophen, so that any women who used other NSAIDs (including naproxen, etodolac, ketoprofen, and sulindac, which are available by prescription) would have been included in the nonuser category. Given that these medications are often used for arthritis or chronic pain, it is likely that a substantial number of the nonusers were actually regular users of prescription NSAIDs. This misclassification of users and nonusers would attenuate any true inverse association between NSAIDs and breast cancer.

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