Do postoperative NSAIDs improve breast cancer outcomes? A Best Evidence Topic.

A Best Evidence Topic was undertaken to systematically review the evidence regarding the use of NSAIDS in breast cancer patients. The search strategy generated 149 titles, of which six were best placed to answer the clinical question. These included three prospective cohort studies, two retrospective cohort studies and one case control study, examining a total of 18,415 breast cancer patients. The study methodologies were highly variable and all relied on approximate measures of NSAID consumption. There is limited evidence that use of aspirin and non-aspirin NSAIDs may be associated with decreased breast cancer mortality and all-cause mortality in patients diagnosed with breast cancer. Optimum type and dosage of NSAID for this purpose remains unclear. There is a need for large-scale randomised controlled trials to further clarify.