Could NSAIDs become a preventative therapy in pregnancy-associated breast cancer?

Abstract

SUMMARY Pregnancy-associated breast cancer (PABC) is a unique type of young women’s breast cancer that includes two biologically distinct conditions: those diagnosed during pregnancy and those diagnosed postpartum. It is the dominant subset of postpartum PABC that is more consistently associated with higher breast cancer mortality. Preclinical work has identified the normal event of postpartum involution as a wound-healing milieu rich in immune cells. We have shown that the involution environment drives tumor growth, proliferation and metastasis. Moreover, we have demonstrated in animal models that this ‘involution effect’ can be abrogated with drug therapy, namely NSAIDs, which target normal involution pathways implicated in PABC tumor promotion. In this perspective, we review the contemporary understanding of PABC, our preclinical modeling and its implications and the unmet research needs required for future translation of these preclinical studies into rational and safe human clinical trials.