Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
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.
Moorman PG. Association of Aspirin Use and Hormone Receptor Status With Breast Cancer Risk. JAMA. 2004;292(12):1426-1427. doi:10.1001/jama.292.12.1426-a