Antipsychotic Medication Use May Augment Risk of Breast Cancer

The use of antipsychotic medications among women is moderately correlated with breast cancer and may be possibly mediated by prolactin-elevating properties of certain medications, according to a recent systematic review and meta-analysis. This finding highlights the significance of the risk-benefit assessment of antipsychotic prescriptions in high-risk patients.

A total of 9 observational studies, including 5 cohort and 4 case-control studies, were ultimately included for review (n = 2,031,380) and 7 for meta-analysis (n = 1,557,013). The authors found that 6 out of 9 studies reported a significant association between the use of antipsychotic medications and increased risk of breast cancer.

Pooled estimates of adjusted hazard ratios extracted from cohort studies and adjusted odds ratios from case-control studies were 1.39 (95% CI; 1.11 – 1.73] and 1.37 (95% CI; 0.90 – 2.09), respectively. These pooled estimates suggested a moderate association.

The extent of antipsychotic exposure, such as a longer duration of use, was associated with a greater risk of breast cancer, particularly for antipsychotics with prolactin-elevating properties. The meta-analysis estimated a moderate positive association of an elevated risk of more than 30% among antipsychotic users when compared with non-users.

The authors noted that elevated breast cancer risk may be explained by hyperprolactinemia and other complications possibly induced by antipsychotic medications, such as central obesity, diabetes, and cardiovascular disease.

The authors concluded that they “found a moderate association between the use of antipsychotics and breast cancer with a more evident association observed with prolactin-elevating medications and greater extent of antipsychotic exposure. This risk, together with other known associated adverse events, should be weighed against the anticipated treatment outcomes for a balanced clinical management decision.”

—Yvette C Terrie, BS. Pharm, R.Ph.

Reference:

Leung JCN, Ng DWY, Chu RYK, et al. Association of antipsychotic use with breast cancer: a systematic review and meta-analysis of observational studies with over 2 million individuals. Epidemiol Psychiatr Sci. 2022;31:e61. Published 2022 Sep 5. doi:10.1017/S2045796022000476