Aspirin Use and Risk of Breast Cancer Recurrence in Chinese Patients

Abstract Background Observational studies have suggested a potential role for aspirin in reducing breast cancer recurrence, but data from Asian populations remain limited. We aimed to evaluate the association between long-term aspirin use and invasive disease-free survival (IDFS) in a cohort of Chinese women with breast cancer. Methods This retrospective matched cohort study included 573 patients who had regularly used low-dose aspirin prior to their breast cancer diagnosis and 573 matched controls who had never used aspirin, selected from patients diagnosed between 2006 and 2020. Patients were matched 1:1 based on age, stage, hormone receptor status, BMI, and year of diagnosis. The primary endpoint was IDFS. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Over a median follow-up of 83.6 months, 50 IDFS patients occurred in the aspirin group and 89 in the non-aspirin group. Aspirin use was associated with a significantly lower risk of invasive disease-free events (HR = 0.63; 95% CI: 0.45–0.89; P = 0.007). Conclusions Among Chinese women with breast cancer, long-term aspirin use was associated with improved IDFS. These findings support further investigation of aspirin as a potential adjuvant strategy, particularly in late stage disease. Impact This study provides real-world evidence from an Asian cohort supporting a possible role of aspirin in reducing breast cancer recurrence risk.