32例乳腺癌保乳手术临床观察

目的观察早期乳腺癌保留乳房手术的治疗效果。方法回顾本院近年来收治32例乳腺癌行保乳手术患者的临床资料,32例均行保乳手术（局部完整切除加腋窝淋巴结清扫）治疗,术后行辅助放化疗和内分泌治疗。结果32例患者术后平均随访12~72个月,无局部复发或远处转移。患侧乳房外形满意,无放疗后乳房纤维化、挛缩。患侧肢体活动良好,无淋巴水肿等并发症发生。结论对早期乳腺癌患者行保乳手术结合术后综合治疗近、远期临床疗效均满意,美容效果好,术后并发症少,可作为早期乳腺癌的首选治疗方法。     

早期乳腺癌保留乳房治疗效果观察

目的观察早期乳腺癌保乳手术的近期效果。方法对可行保乳的12例患者先行局部切除肿瘤和部分乳腺组织，清扫同侧腋窝淋巴结，检查胸肌间淋巴结，术后根治性放疗。对照组29例患者行乳房全切加同侧腋窝淋巴结清扫术。腋窝淋巴结阳性者行CAF方案治疗，ER阳性者服用TAM5年。结果保乳术占同期乳腺癌手术的4．1％，保乳术组中住随访28个月，有2例局部复发16％；全乳切除术组中住随访31个月，无局部复发。1例发生对侧乳腺癌（3．4％）；两组均无远处转移及死亡病例。保乳术组美容效果满意率为92．9％。结论对早期乳腺癌在严格掌握指征的前提下保留乳房是切实可行的，术后要正规化疗、放疗及内分泌治疗。     

保乳手术治疗早期乳腺癌12例临床分析

目的探讨乳腺癌采用保乳手术,术后配合放、化、免疫等多种综合治疗的疗效。方法对12例早期乳腺癌患者进行保留乳房肿瘤切除加腋窝淋巴结清扫术,术后二周做放疗、化疗。结果术后随访24～36个月,全部存活,无1例复发。结论早期乳腺癌采用保乳手术治疗效果满意。     

156例早期乳腺癌保乳治疗的回顾性分析

目的对早期乳腺癌保乳手术加辅助治疗的美容效果及近期疗效进行观察。方法回顾性分析日照市人民医院1998～2005年收治的156例Ⅰ～Ⅱa期实施保乳治疗的乳腺癌患者。所有患者均行乳房肿块局部扩大切除及腋窝淋巴结清扫术,术后均接受放射治疗58～60 Gy,并对浸润性乳腺癌患者行辅助化疗4～8周期。化放疗结束后,对激素受体阳性患者行三苯氧胺或来曲唑等内分泌治疗,对患者乳房外形进行评价,对生存情况进行随访。结果手术并发症发生率为15.4%,乳房外观评价为优良、一般和较差分别为102例(65.4%)、50例(32.1%)和4例(2.5%)。患者3年总生存率为95.5%,3年无病生存率为92.3%,局部复发率为6.4%。结论保乳手术治疗早期乳腺癌疗效确切,术前严格掌握手术适应证及术后行规范的辅助治疗是保乳手术获得良好疗效的保证。     

保留乳头乳晕复合体乳腺癌改良根治术后背阔肌肌皮瓣乳房再造

目的研究保留乳头乳晕复合体乳腺癌改良根治术后背阔肌肌皮瓣乳房再造安全性与美观性。方法 2005年1月-2011年4月30例早期乳腺癌,在保留乳头、乳晕改良根治术的同时进行背阔肌肌皮瓣乳房再造。结果 30例手术均成功,术后1例出现乳头部分坏死,术后1例出现再造乳房僵硬,术后腋窝形态美观,腋窝无1例积液,5d拔出引流管,20例患者术后半年左右乳头恢复感觉。术后患者均随访1-5年,术后无1例出现局部复发,1例4年后出现肺部转移。重建的乳房形态完美,增加了美感,减轻了患者的精神负担。结论保留乳头乳晕复合体乳腺癌改良根治术后背阔肌肌皮瓣乳房再造,不但有改良根治术相同的安全性,而且有更好的美观性,可望作为早期乳腺癌手术治疗的常规选择术式。     

早期乳腺癌保乳手术24例效果分析

目的 探讨早期乳腺癌保乳手术的临床疗效。方法 对24例早期乳腺癌患者实施肿块局部扩大切除＋腋窝淋巴结清扫，术后均予以辅助放疗和全身化疗。结果 24例患者均获随访1．5～5．0年，1例于术后3年内发生局部复发并肺转移死亡。病侧乳房外形均较好，两侧乳房基本对称。结论 保乳手术联合辅助放疗和全身化疗治疗早期乳腺癌疗效肯定，美容效果良好。     

乳癌保留乳房手术中近期疗效分析

目的：探讨乳腺癌保留手术这一新术式15年的治疗效果和美容效果，方法：对1996．4－2001．3月收治11例临床Ⅰ-Ⅱa期乳腺癌患者行保留乳房手术的资料进行回顾性分析，对术后腋淋巴结转移、局部复发，腋窝区复发情况进行分析，并对美容效果进行观察，结果：11例中3例行局部切除腋淋巴结清扫术，8例行区段切除腋淋巴结清扫术，9例行术后化疗，1例未行术后化疗，全部病例均行术后放疗，全部病例未出现术后复发和转移。美容效果较好。结论：Ⅰ-Ⅱa期乳腺癌患者可行保留乳房手术，手术效果肯定，美容效果较好。     

保乳术和根治术治疗乳腺癌综合评价

目的评价早期乳腺癌行保乳手术加术后放、化疗综合治疗的疗效。方法I、II期乳腺癌患者行保留乳房的肿瘤切除加腋窝淋巴结清除术患者40例(保乳组),同期行乳腺癌改良根治术患者40例(对照组),术后早期予以全身化疗、全乳腺区放疗和(或)内分泌治疗。结果全部病例中位随访53个月,保乳组中无局部复发者,对照组局部复发1例;保乳组和对照组的3和5年生存率分别为94.2%(33/35)和88.0%(22/25),P=0.9878;94.1%(32/34)和87.5%(21/24),P=0.9980;远隔脏器转移率分别为7.5%和5.3%,P=0.9794。两组间各项指标比较差异均无统计学意义,患侧乳房外形的优良率达96.2%。结论早期乳腺癌采用保留乳房手术加术后放、化疗综合治疗,疗效与根治术相似,美容效果好,可作为首选方法之一。     

保乳手术治疗早期乳腺癌效果观察

目的:探讨保乳手术治疗早期乳腺癌的术式、手术效果及美容效果。方法:随机选取早期乳腺癌患者68例,依据患者意愿,分为保乳手术治疗者38例(保乳组)、保留胸大肌的乳腺癌改良根治术者30例(根治组),分别予以保乳手术、改良根治术,术后及随访观察治疗效果,评价乳腺美容效果。结果:两组患者手术均顺利完成,术后恢复良好,均未见局部复发或远处转移等;对术后1年以上的患者进行乳房外形评估,保乳组与根治组的优良率分别为94.74%、70.00%,两组比较,差异有统计学意义(P<0.05)。结论:早期乳腺癌患者实施保乳手术加综合治疗,创伤小,兼顾疗效及美容效果,提高了患者生活质量,是早期乳腺癌患者的首选治疗方式。     

早期乳腺癌保乳手术的临床疗效分析

目的观察早期乳腺癌保乳综合治疗的效果和可行性。方法对17例早期乳腺癌患者实行保乳手术,其中Ⅰ期13例,Ⅱ期4例。所有患者行单纯肿瘤切除加腋窝淋巴结清扫,术后辅助放疗和化疗。结果17例病人手术恢复顺利,随访时间6～22个月,仅1例腋窝有淋巴结转移灶（复发率6％）,乳房外观丰满、良好。美容效果优良率达88％（15／17）。结论早期行保乳区段切除综合疗法治疗乳腺癌,方法简单,治愈率未降低、复发率未增加而外观更美丽,病人从生理、心理方面易接受,对提高病人综合生活质量起到良好作用。     

脑电双频指数仪在不同年龄全身麻醉患儿中监测麻醉深度的应用

目的探讨在不同年龄患儿全身麻醉中用脑电双频指数仪监测麻醉深度的可行性。方法患儿40例,按美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级为Ⅰ或Ⅱ级,接受全身麻醉,气管插管和择期手术。麻醉用静脉注射丙泊酚/瑞芬太尼诱导,持续静脉输入丙泊酚/瑞芬太尼维持。患儿按年龄分为4组(每组10例):A组(≤3月),B组(>3月,≤2岁),C组(>2岁,≤6岁)和D组(>6岁,≤12岁)。诱导前(T1)、诱导后(T2)、插管时(T3)、切皮时(T4)、停药时(T5)、自主呼吸恢复(T6)和拔管时(T7),做密西根大学镇静评分(University of Michigan Sedation Scale,UMSS),并记录脑电双频指数(bispectralindex,BIS)值。记录麻醉后自主呼吸恢复时间(T5~T6),麻醉后气管拔管时间(T5~T7)。结果(1)各组患儿,T1镇静评分为0~1分;T2时上升,T4为4分,T7回到T1时水平(0~1分)。与此对应,(2)各组患儿T1时的BIS值在96以上,T2时BIS值明显下降,差异有统计学意义(P<0.01),T7回到T1水平。(3)A组患儿与B、C、D组患儿相比,麻醉后气管拔管时间明显延长,差异有统计学意义(P<0.01)。(4)4组患儿麻醉后自主呼吸恢复时间差异无统计学意义。结论在不同年龄全身麻醉患儿中,脑电双频指数仪可以有效监测麻醉深度。     

Effect of Nancy Reagan's Mastectomy on Choice of Surgery for Breast Cancer by US Women

Context.— While the actions of popular figures are believed to influence the behavior of the general public, including health care decisions, little research has examined such an effect. Objective.— To determine whether a temporal association exists between use of breast-conserving surgery (BCS) for treatment of breast cancer and Nancy Reagan's mastectomy in October 1987. Design/Setting.— Population-based observational cohort study. Patients.— Two sources of data: (1) 82230 women aged 30 years and older who were included in the Surveillance, Epidemiology, and End Results tumor registry because of a diagnosis of local or regional breast cancer from 1983 to 1990; and (2) 80057 female Medicare beneficiaries aged 65 to 79 years who received inpatient surgery for local or regional breast cancer in 1987 or 1988. Main Outcome Measure.— Percentage of use of BCS vs mastectomy over time. Results.— Compared with women undergoing surgery for breast cancer in the third quarter of 1987 (just prior to Mrs Reagan's mastectomy), women were 25% less likely to undergo BCS in the fourth quarter of 1987 (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.66-0.85) and in the first quarter of 1988 (OR, 0.76; 95% CI, 0.67-0.86). In subsequent quarters, the rate returned to the baseline. In multivariate analyses, the decline was significant among white but not nonwhite women. It was most prominent among women aged 50 to 79 years in the central and southern regions of the country, and most sustained among women living in areas with lower levels of income and education. Conclusions.— Celebrity role models can influence decisions about medical care. The influence appears strongest among persons who demographically resemble the celebrity, and those of lower income and educational status.      

Establishment of novel rat models for premalignant breast disease

Background Breast cancer has become one of the most common malignant tumors among females over the past several years.Breast carcinogenesis is a continuous process,which is featured by the normal epithelium progressing to premalignant lesions and then to invasive breast cancer （IBC）.Targeting premalignant lesions is an effective strategy to prevent breast cancer.The establishment of animal models is critical to study the mechanisms of breast carcinogenesis,which will facilitate research on breast cancer prevention and drug behaviors.In this study,we established a feasible chemically-induced rat model of premalignant breast cancer.Methods Following the administration of the drugs （carcinogen,estrogen,and progestogen） to Sprague-Dawley （SD） rats,tumors or suspicious tumors were identified by palpation or ultrasound imaging,and were surgically excised for pathological evaluation.A series of four consecutive steps were carried out in order to determine the carcinogen：7,12-dimethylbenzaanthracene （DMBA） or 1-methyl-1-nitrosourea,the route of carcinogen administration,the administration period of estrogen and progestogen,and the DMBA dosage.Results Stable premalignant lesions can be induced in SD rats on administration of DMBA （15 mg/kg,administered three times） followed by administration of female hormones 5-day cycle.Results were confirmed by ultrasound and palpation.Conclusion Under the premise of drug dose and cycle,DMBA combined with estrogen and progestogen can be used as a SD rat model for breast premalignant lesions.     

The effect of preoperative intravenous paracetamol administration on postoperative fever in pediatrics cardiac surgery

Background:

Post-operative fever is a common complication of cardiac operations, which is known to be correlated with a greater degree of cognitive dysfunction 6 weeks after cardiac surgery. The aim of the present study was to examine efficacy and safety of single dose intravenous Paracetamol in treatment of post-operative fever in children undergoing cardiac surgery.

Materials and Methods:

In this randomised, double-blind, placebo-controlled clinical trial, 80 children, aged 1-12 years, presenting for open heart surgery were entered in the trial and randomly allocated into two groups: Placebo and Paracetamol. After induction of anaesthesia, 15 mg/kg intravenous Paracetamol solution was infused during 1 h in the Paracetamol group. Patients in placebo group received 15 mg/kg normal saline infusion during the same time. Since the end of operation until next 24 h in intensive care unit, axillary temperature of the two group patients was recorded in 4-h intervals. Any fever that occurred during this period had been treated with Paracetamol suppository (125 mg) and the amount of antipyretic drug consumption for each patient had been recorded. In order to examine the safety of Paracetamol, patients were evaluated for drug complication at the same time.

Results:

Mean axillary temperature during first 24 h after operation was significantly lower in Paracetamol group compared with placebo group (P = 0.001). Overall fever incidence during 24 h after operation was higher in placebo group compared with Paracetamol group (P = 0.012). Of Paracetamol group patients, 42.5% compared with 15% of placebo group participants had no consumption of antipyretic agent (Paracetamol suppository) during 24 h after operation (P = 0.001).

Conclusion:

This study suggests that single dose administration of intravenous Paracetamol before paediatric cardiac surgeries using cardiopulmonary bypass; reduce mean body temperature in the first 24 h after operation.     

Corticosteroids for the prevention of atrial fibrillation after cardiac surgery: a randomized controlled trial

Context  Atrial fibrillation (AF) is the most common arrhythmia to occur after cardiac surgery. An exaggerated inflammatory response has been proposed to be one etiological factor. Objective  To test whether intravenous corticosteroid administration after cardiac surgery prevents AF after cardiac surgery. Design, Setting, and Patients  A double-blind, randomized multicenter trial (study enrollment August 2005–June 2006) in 3 university hospitals in Finland of 241 consecutive patients without prior AF or flutter and scheduled to undergo first on-pump coronary artery bypass graft (CABG) surgery, aortic valve replacement, or combined CABG surgery and aortic valve replacement. Intervention  Patients were randomized to receive either 100-mg hydrocortisone or matching placebo as follows: the first dose in the evening of the operative day, then 1 dose every 8 hours during the next 3 days. In addition, all patients received oral metoprolol (50-150 mg/d) titrated to heart rate. Main Outcome Measure  Occurrence of AF during the first 84 hours after cardiac surgery. Results  The incidence of postoperative AF was significantly lower in the hydrocortisone group (36/120 [30%]) than in the placebo group (58/121 [48%]; adjusted hazard ratio, 0.54; 95% confidence interval, 0.35-0.83; P = .004; number needed to treat, 5.6). Compared with placebo, patients receiving hydrocortisone did not have higher rates of superficial or deep wound infections, or other major complications. Conclusion  Intravenous hydrocortisone reduced the incidence of AF after cardiac surgery. Trial Registration  clinicaltrials.gov Identifier: NCT00442494      

Physical activity and survival after breast cancer diagnosis

Context  Physical activity has been shown to decrease the incidence of breast cancer, but the effect on recurrence or survival after a breast cancer diagnosis is not known. Objective  To determine whether physical activity among women with breast cancer decreases their risk of death from breast cancer compared with more sedentary women. Design, Setting, and Participants  Prospective observational study based on responses from 2987 female registered nurses in the Nurses’ Health Study who were diagnosed with stage I, II, or III breast cancer between 1984 and 1998 and who were followed up until death or June 2002, whichever came first. Main Outcome Measure  Breast cancer mortality risk according to physical activity category (<3, 3-8.9, 9-14.9, 15-23.9, or 24 metabolic equivalent task [MET] hours per week). Results  Compared with women who engaged in less than 3 MET-hours per week of physical activity, the adjusted relative risk (RR) of death from breast cancer was 0.80 (95% confidence interval [CI], 0.60-1.06) for 3 to 8.9 MET-hours per week; 0.50 (95% CI, 0.31-0.82) for 9 to 14.9 MET-hours per week; 0.56 (95% CI, 0.38-0.84) for 15 to 23.9 MET-hours per week; and 0.60 (95% CI, 0.40-0.89) for 24 or more MET-hours per week (P for trend = .004). Three MET-hours is equivalent to walking at average pace of 2 to 2.9 mph for 1 hour. The benefit of physical activity was particularly apparent among women with hormone-responsive tumors. The RR of breast cancer death for women with hormone-responsive tumors who engaged in 9 or more MET-hours per week of activity compared with women with hormone-responsive tumors who engaged in less than 9 MET-hours per week was 0.50 (95% CI, 0.34-0.74). Compared with women who engaged in less than 3 MET-hours per week of activity, the absolute unadjusted mortality risk reduction was 6% at 10 years for women who engaged in 9 or more MET-hours per week. Conclusions  Physical activity after a breast cancer diagnosis may reduce the risk of death from this disease. The greatest benefit occurred in women who performed the equivalent of walking 3 to 5 hours per week at an average pace, with little evidence of a correlation between increased benefit and greater energy expenditure. Women with breast cancer who follow US physical activity recommendations may improve their survival.      

Pregnancy characteristics and maternal risk of breast cancer

Context  During pregnancy, serum levels of estrogen, progesterone, and other hormones are markedly higher than during other periods of life. Pregnancy hormones primarily are produced in the placenta, and signs of placental impairment may serve as indirect markers of hormone exposures during pregnancy. During pregnancy, these markers have been inconsistently associated with subsequent risk of breast cancer in the mother. Objective  To examine associations between indirect markers of hormonal exposures, such as placental weight and other pregnancy characteristics, and maternal risk of developing breast cancer. Design and Setting  Population-based cohort study using data from the Swedish Birth Register, the Swedish Cancer Register, the Swedish Cause of Death Register, and the Swedish Register of Population and Population Changes. Participants  Women included in the Sweden Birth Register who delivered singletons between 1982 and 1989, with complete information on date of birth and gestational age. Women were followed up until the occurrence of breast cancer, death, or end of follow-up (December 31, 2001). Cox proportional hazards models were used to estimate associations between hormone exposures and risks of breast cancer. Main Outcome Measure  Incidence of invasive breast cancer. Results  Of 314 019 women in the cohort, 2216 (0.7%) developed breast cancer during the follow-up through 2001, of whom 2100 (95%) were diagnosed before age 50 years. Compared with women who had placentas weighing less than 500 g in 2 consecutive pregnancies, the risk of breast cancer was increased among women whose placentas weighed between 500 and 699 g in their first pregnancy and at least 700 g in their second pregnancy (or vice versa) (adjusted hazard ratio, 1.82; 95% confidence interval [CI], 1.07-3.08), and the corresponding risk was doubled among women whose placentas weighed at least 700 g in both pregnancies (adjusted hazard ratio, 2.05; 95% CI, 1.15-3.64). A high birth weight (4000 g) in 2 successive births was associated with an increased risk of breast cancer before but not after adjusting for placental weight and other covariates (adjusted hazard ratio, 1.10; 95% CI, 0.76-1.59). Conclusions  Placental weight is positively associated with maternal risk of breast cancer. These results further support the hypothesis that pregnancy hormones are important modifiers of subsequent maternal breast cancer risk.      

Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial

Context  Tamoxifen is approved for the reduction of breast cancer risk, and raloxifene has demonstrated a reduced risk of breast cancer in trials of older women with osteoporosis. Objective  To compare the relative effects and safety of raloxifene and tamoxifen on the risk of developing invasive breast cancer and other disease outcomes. Design, Setting, and Patients  The National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene trial, a prospective, double-blind, randomized clinical trial conducted beginning July 1, 1999, in nearly 200 clinical centers throughout North America, with final analysis initiated after at least 327 incident invasive breast cancers were diagnosed. Patients were 19 747 postmenopausal women of mean age 58.5 years with increased 5-year breast cancer risk (mean risk, 4.03% [SD, 2.17%]). Data reported are based on a cutoff date of December 31, 2005. Intervention  Oral tamoxifen (20 mg/d) or raloxifene (60 mg/d) over 5 years. Main Outcome Measures  Incidence of invasive breast cancer, uterine cancer, noninvasive breast cancer, bone fractures, thromboembolic events. Results  There were 163 cases of invasive breast cancer in women assigned to tamoxifen and 168 in those assigned to raloxifene (incidence, 4.30 per 1000 vs 4.41 per 1000; risk ratio [RR], 1.02; 95% confidence interval [CI], 0.82-1.28). There were fewer cases of noninvasive breast cancer in the tamoxifen group (57 cases) than in the raloxifene group (80 cases) (incidence, 1.51 vs 2.11 per 1000; RR, 1.40; 95% CI, 0.98-2.00). There were 36 cases of uterine cancer with tamoxifen and 23 with raloxifene (RR, 0.62; 95% CI, 0.35-1.08). No differences were found for other invasive cancer sites, for ischemic heart disease events, or for stroke. Thromboembolic events occurred less often in the raloxifene group (RR, 0.70; 95% CI, 0.54-0.91). The number of osteoporotic fractures in the groups was similar. There were fewer cataracts (RR, 0.79; 95% CI, 0.68-0.92) and cataract surgeries (RR, 0.82; 95% CI, 0.68-0.99) in the women taking raloxifene. There was no difference in the total number of deaths (101 vs 96 for tamoxifen vs raloxifene) or in causes of death. Conclusions  Raloxifene is as effective as tamoxifen in reducing the risk of invasive breast cancer and has a lower risk of thromboembolic events and cataracts but a nonstatistically significant higher risk of noninvasive breast cancer. The risk of other cancers, fractures, ischemic heart disease, and stroke is similar for both drugs. Trial Registration  clinicaltrials.gov Identifier: NCT00003906      

Hormone Replacement Therapy and Risk of Breast Cancer With a Favorable Histology: Results of the Iowa Women's Health Study

Context  Long-term, postmenopausal use of hormone replacement therapy (HRT) appears to increase breast cancer risk. Whether the effect of HRT use on risk of breast cancer varies among histological types of invasive carcinoma is unknown. Objective  To determine associations between HRT use and risk of ductal carcinoma in situ (DCIS), invasive carcinoma with favorable histology, and invasive ductal or lobular carcinoma. Design  Prospective cohort study whose participants were followed up continuously for 11 years from January 1986 to December 1996. Setting and Participants  Iowa Women's Health Study, a population-based random sample of postmenopausal women aged 55 to 69 years in 1986. A total of 1520 incident breast cancer cases occurred in the at-risk cohort of 37,105 women. Main Outcome Measures  Multivariate-adjusted relative risk (RR) of tumor-specific breast cancers associated with duration of ever, current, or past HRT use. Results  Duration of ever HRT use was associated with risk of invasive carcinoma with a favorable histology, with an RR of 1.81 (95% confidence interval [CI], 1.07-3.07) for those who used HRT 5 or fewer years vs an RR of 2.65 (95% CI, 1.34-5.23) for those who used HRT for more than 5 years (P for trend=.005) after adjustment for age and other breast cancer risk factors. There was no association between ever HRT use and the incidence of DCIS or invasive ductal or lobular carcinoma. Among current hormone users, after adjusting for age and other breast cancer risk factors, the RRs (95% CIs) of invasive carcinoma with a favorable histology were 4.42 (2.00-9.76) and 2.63 (1.18-5.89) for 5 or fewer years of use and for more than 5 years of use, respectively. Risk of invasive ductal or lobular carcinoma was associated with current use (5 years) of HRT with an RR of 1.38 (95% CI, 1.03-1.85). Conclusions  Exposure to HRT was associated most strongly with an increased risk of invasive breast cancer with a favorable prognosis. These data add important clinical information for assessing the risks and benefits of HRT use.      

Association of frequency and duration of aspirin use and hormone receptor status with breast cancer risk

Context  Use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) has been associated with a decrease in the risk of several cancers, including breast cancer. NSAIDs inhibit cyclooxygenase activity and thereby reduce prostaglandin synthesis; prostaglandins stimulate aromatase gene expression and thereby stimulate estrogen biosynthesis. Given the importance of estrogen in the pathogenesis of breast cancer, the ability of aspirin and other NSAIDs to protect against breast cancer could vary according to hormone receptor status. Objectives  To determine the association between the frequency and duration of use of aspirin and other NSAIDs and breast cancer risk and to investigate whether any observed association is more pronounced for women with hormone receptor–positive breast cancers. Design, Setting, and Patients  Population-based case-control study of women with breast cancer, including in-person interviews conducted on Long Island, NY, during 1996-1997 (1442 cases and 1420 controls). Main Outcome Measure  Incident invasive and in situ breast cancer by aspirin and NSAID use and hormone receptor status. Results  Ever use of aspirin or other NSAIDs at least once per week for 6 months or longer was reported in 301 cases (20.9%) and 345 controls (24.3%) (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.66-0.97 for ever vs nonusers). The inverse association was most pronounced among frequent users (=" BORDER="0">7 tablets per week) (OR, 0.72; 95% CI, 0.58-0.90). The results for ibuprofen, which was used by fewer women on a regular basis, were generally weaker (OR, 0.78; 95% CI, 0.55-1.10 for <3 times per week vs OR, 0.92; 95% CI, 0.70-1.22 for =" BORDER="0">3 times per week). Use of acetaminophen, an analgesic that does not inhibit prostaglandin synthesis, was not associated with a reduction in the incidence of breast cancer. The reduction in risk with aspirin use was seen among those with hormone receptor–positive tumors (OR, 0.74; 95% CI, 0.60-0.93) but not for women with hormone receptor–negative tumors (OR, 0.97; 95% CI, 0.67-1.40). Conclusion  These data add to the growing evidence that supports the regular use of aspirin and other NSAIDs (which may operate through inhibition of estrogen biosynthesis) as effective chemopreventive agents for breast cancer.