ABC | Volume 111, Nº2, August 2018

Review Article Leite et al Aspirin and hormonal therapy in breast cancer Arq Bras Cardiol. 2018; 111(2):205-212 and mortality are still high, with considerable side effects and high financial costs. There are great expectations regarding new treatments, with low toxicity and cost reduction. Aspirin has been incorporated into clinical practice for over 100 years at a low cost, making it attractive as a potential adjunct treatment. The observational studies included in this review suggest a reduction in the risk of breast cancer in patients regularly taking aspirin. Randomized clinical trials are required to assess the impact of aspirin use on breast cancer prevention, whether associated with endocrine therapy or disease-free survival in breast cancer patients. Aspirin use is a consensus for the secondary prevention of myocardial infarction and ischemic CVA in patients with pre-existing cardiovascular disease and for primary prevention in high-risk groups. Current indications for the prophylactic use of aspirin are based on cardiovascular risk, considering the side effects, especially gastrointestinal bleeding, of which incidence increases with age. Other potential benefits of using aspirin need to be proven in the context of cancer. Conclusion Breast cancer is the most frequently diagnosed tumor in women worldwide, with a significant impact on morbidity and mortality. Although there are controversies in the analyzed studies, considering the possible benefits regarding breast cancer prevention and reduction in cardiovascular events, this systematic review suggests that therapy with selective estrogen receptor modulators and aspirin should be better investigated, and emphasizes the need for randomized trials. Future studies should address issues such as dose, age at the start, duration, efficacy, and safety of a clearly defined treatment regimen. Author contributions Conception and design of the research and Acquisition of data: Leite AM, Martins WA; Analysis and interpretation of the data: Leite AM, Macedo AVS, Jorge AJL, Martins WA; Writing of the manuscript: Leite AM; Critical revision of the manuscript for intellectual content: Macedo AVS, Jorge AJL, Martins WA. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This article is a research product in Cardio-oncology of the Master submitted by Andréa de Melo Leite, fromUniversidade Federal Fluminense. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 1. Ch Yiannakopoulou E. Interaction of salicylates and the other nonsteroidal anti-inflammatoryagentswithbreastcancerendocrinetreatment:systematic review. 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