O uso de anti-inflamatórios e o câncer de mama: uma revisão sistemática

Abstract

Breast cancer is a prominent global health issue with a high incidence and mortality rate. Its occurrence is associated with environmental and lifestyle factors, as well as genetic factors. Chronic inflammation has been observed to be a trigger for neoplastic development, with the presence of pro-inflammatory cells and mediators contributing to a microenvironment conducive to tumor cell proliferation. Anti-inflammatories are a class of medications used in various clinical situations and classified as non-steroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 (COX-2) selective inhibitors (COXIBs), and steroids (glucocorticoids). Their primary function is to resolve symptoms such as edema, fever, and pain, and are related to inflammatory diseases such as asthma and arthritis. Based on NSAIDs, their pharmacological effects are achieved through their action against pro-inflammatory mediators, such asinhibiting the cyclooxygenase enzyme. Regarding breast cancer and probable antitumor effects of anti-inflammatory drugs, published studies show inconsistent results. Thus, the objective of this work was to systematize and update the information of clinical studies acquired in databases, on the effect of the use of anti-inflammatory drugs in breast cancer. To do so, a systematic review of secondary data and original articles available in the literature was performed between December 13, 2021, and August 17, 2022, gathering clinical trials on the relationship between anti-inflammatory use and breast cancer in databases such as Pubmed, Science Direct, Biblioteca Virtual em Saúde, and Cochrane. The studies were grouped based on the pharmacological therapy used, and independent variables were considered. After applying the inclusion and exclusion criteria, 11 articles met the criteria and underwent methodological evaluation by the Jadad Scale and risk of bias analysis by RoB 2.0 and ROBINS-I. Regarding the outcomes of the studies, 54.54% concluded that the risk of breast cancer is inversely associated with anti-inflammatory use, with the authors suggesting that the use of anti-inflammatories may indeed be associated with prevention, chemotherapeutic effect, and a better treatment or decreased risk of breast cancer.