[Prolactin, antipsychotics and breast cancer: is there a connection?].

BACKGROUND

The use of antipsychotics can result in elevated prolactin levels or hyperprolactinemia. An increasing number of studies suggests that prolactin plays a role in mammary carcinogenesis, leading to concerns about a possible relationship between antipsychotics and breast cancer.

OBJECTIVE

To provide an overview of recent literature regarding the relationship between prolactin, antipsychotics and breast cancer and an association between schizophrenia and breast cancer.

METHODS

We used PubMed to search for English- or Dutch-language articles concerning breast cancer risk (factors), prolactin, antipsychotics and schizophrenia.

RESULTS

Studies have not shown any causal link between antipsychotics and the development of breastcancer. Moreover, antipsychotic medication seems to have no influence on locally produced prolactin - which some experts believe plays a role in the tumor genesis - and certain antipsychotics actually provide protection against breast cancer. There are conflicting reports on the prevalence of breast cancer among patients with schizophrenia. Nevertheless, research has revealed that several well-known risk factors for breast cancer (such as an unhealthy lifestyle) are more prevalent in patients with schizophrenia.

CONCLUSIONS

There is no conclusive evidence that antipsychotic medication that raises prolactin levels increases the risk of breast cancer. Nevertheless, clinicians should always be cautious about prescribing antipsychotics for breast cancer patients. In our view, clinicians should always treat breast cancer risk factors as efficiently as possible, particularly when attending to patients who have schizophrenia.