Original scientific paper

ANTIPSYCHOTIC TREATMENT, PROLACTIN, AND BREAST TUMORIGENESIS

Marc De Hert ; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Department of Neurosciences, Kortenberg, Belgium
Davy Vancampfort ; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Department of Neurosciences, Kortenberg, Belgium
Brendon Stubbs ; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, King’s College London, London, United Kingdom
Tine Sabbe ; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Department of Neurosciences, Kortenberg, Belgium
Hans Wildiers ; KU Leuven - University of Leuven, Department of General Medical Oncology and Multidisciplinary Breast Center, University Hospitals Leuven, B-3000 Leuven, Belgium
Johan Detraux ; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Department of Neurosciences, Kortenberg, Belgium

Abstract

Background: Over the last decades prolactin (PRL) has gained attention for its possible role in breast tumorigenesis. As all
antipsychotics (although differences with respect to PRL elevation are large) have the propensity to induce hyperprolactinemia
(HPRL), questions have arisen concerning the influence of PRL-elevating antipsychotic medications on breast cancer risk.
Subjects and methods: A literature search (until January 2016), using the MEDLINE database, was conducted for Englishlanguage
published clinical studies to identify and synthesize data of the current state of knowledge concerning the relationship
between HPRL, breast cancer risk (factors) and antipsychotic medication.
Results: Results of human prospective studies evaluating the relationship between pre-diagnostic circulating PRL levels and
breast cancer risk are limited, equivocal and only correlational. Associations between higher circulating PRL levels and other breast
cancer risk factors than nulliparity and hormone therapies mostly have been negative for both pre-and postmenopausal women. Until
today, no causal link between (chronic) administration of antipsychotics and breast tumorigenesis in humans has been demonstrated.
Finally, several reports describe mechanisms of cancer protection with the PRL hormone as well as with antipsychotic medication.
Conclusion: The role of PRL in breast carcinogenesis therefore remains unclear, unconfirmed, yet controversial. Antipsychotics
should not be withhold for breast cancer prevention reasons to patients in need of this sometimes life-saving medication, even if
classical breast cancer risk factors are present.

Keywords

breast cancer; prolactin; antipsychotics

Hrčak ID:

176261

URI

https://hrcak.srce.hr/176261

Publication date:

15.9.2016.

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