Different doses did not yield different results.
The authors acknowledged that, given that almost all of the studies reviewed were observational, this analysis may be subject to the certain limitations, and all such analyses are only as good as the studies they review.
On the other hand, the review was a large one and has biological plausibility. The inhibition of the enzyme cyclooxygenase (COX) is thought to be one of the ways NSAIDs might reduce cancer risk. And, according to an accompanying editorial, cox-2 is over expressed by 40 percent in invasive breast cancer and 80 percent in colorectal cancer.
At the very least, the results should prompt further research.
"The question is, how can you apply these results? These drugs are widely used but not without side effects. You're not going to put someone on ibuprofen long-term, because it's not going to help the stomach, and there are kidney effects," said Dr. Debra Monticciolo, a professor of radiology at Texas A&M Health Science Center and vice chair of research in the radiology department and chief of breast imaging at Scott & White Hospital. "This is preliminary. You're looking at an observational meta-analysis. It's not the strength of a randomized, controlled trial. You want long-term efficacy and long-term safety data. We need more information."
A randomized trial looking at the protective effect of Celebrex on breast cancer is due to be completed in 2009, Etminan said.
The American Cancer Society has more on breast cancer.
SOURCES: Mahyar Etminan, Pharm.D., assistant professor, medicine, Univers
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