Prolactin and breast cancer: the need to avoid undertreatment of serious psychiatric illnesses in breast cancer patients: a review

Prolactin and breast cancer: the need to avoid undertreatment of serious psychiatric illnesses in breast cancer patients: a review

Author Brandao, Denise Froes Autor UNIFESP Google Scholar
Strasser-Weippl, Kathrin Google Scholar
Goss, Paul E. Google Scholar
Abstract Hyperprolactinemia, defined as a sustained elevation of prolactin (PRL) levels greater than 530 mIU/L in women and greater than 424 mIU/L in men, has been implicated for a long time in breast cancer etiology and prognosis. Elevated PRL values (approximately 2-3 times higher than the reference values) are a common adverse effect of antipsychotic medications, especially with first-generation drugs, and most antipsychotics carry a standard warning regarding PRL elevations on their US product labels. These associations foster undertreatment of serious psychiatric illnesses in both otherwise healthy patients and cancer patients. This review assesses both the preclinical and clinical evidence that has led to the hypothesis of PRL's role in breast cancer risk or breast cancer progression. It is concluded that taken together, the published data are unconvincing and insufficient to deprive cancer patients in general and breast cancer patients specifically of potentially effective antipsychotic or antidepressant medications for serious psychiatric indications. We thus call on revised medication guidelines to avoid the existing undertreatment of serious psychiatric illnesses among cancer patients based on an unproven contraindication to psychiatric medications. Cancer 2016;122:184-188. (c) 2015 American Cancer Society. This review discusses the evidence for a role of hyperprolactinemia in breast cancer risk and prognosis. New guidelines are needed for antipsychotic and antidepressant medications among cancer patients.
Keywords Antidepressive Agents
Antipsychotic Agents
Breast Neoplasms
Depression
ProlactinPostmenopausal Women
Replacement Therapy
Plasma Prolactin
Depression
Risk
Mortality
Receptor
Growth
Cohort
Drugs
Language English
Date 2016
Published in Cancer. Hoboken, v. 122, n. 2, p. 184-188, 2016.
ISSN 0008-543X (Sherpa/Romeo, impact factor)
Publisher Wiley
Extent 184-188
Origin https://doi.org/10.1002/cncr.29714
Access rights Open access Open Access
Type Revisão
Web of Science ID WOS:000368009600006
URI http://repositorio.unifesp.br/handle/11600/49181

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