Breast Cancer risk in patients with dopamine agonist-treated hyperprolactinemia.

IF 5.4 2区 医学 Q1 Medicine Journal of Endocrinological Investigation Pub Date : 2024-10-30 DOI:10.1007/s40618-024-02492-2
Laura Dery, Ilan Shimon, Yaron Rudman, Hiba Masri Iraqi, Shiri Kushnir, Tzipora Shochat, Odelia Cooper, Amit Akirov
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Abstract

Purpose: Given prolactin's (PRL) multifaceted roles in mammary tissue, an association between hyperprolactinemia and breast cancer has been hypothesized. Despite previous studies not identifying this risk, we aimed to investigate whether a connection exists.

Methods: This retrospective cohort study compared breast cancer incidence in patients with dopamine agonist (DA)-treated hyperprolactinemia versus matched controls in a 1:5 ratio. The primary outcome was a breast cancer diagnosis following hyperprolactinemia diagnosis.

Results: The cohort consisted of 1484 female patients with DA-treated hyperprolactinemia matched to 7418 female controls (mean age at diagnosis 32.70 ± 11.12 years; BMI 25.60 ± 5.84 kg/m2). Breast cancer was diagnosed in 27 patients with hyperprolactinemia (1.82%) and 97 controls (1.31%) (HR 1.40, 95% CI 0.91-2.14, p = 0.12). Patients who developed breast cancer were diagnosed with hyperprolactinemia later in life than those who did not (median age 42.63 vs. 29.79 years; p < 0.0001). Patients with PRL < 5× upper limit of normal (ULN) at diagnosis developed breast cancer at a higher rate than controls (2.25% vs. 1.33%; HR 1.73, 95% CI 1.09-2.75), but the difference was not significant in patients with PRL ≥ 5×ULN. Patients who exhibited longer times to PRL normalization had higher incidence of breast cancer (median 2.60 vs. 1.41 years in those who did not develop breast cancer; p = 0.03).

Conclusion: Overall, patients with DA-treated hyperprolactinemia did not show an increased risk for breast cancer compared to controls. However, the risk was significantly higher among those whose PRL levels were < 5×ULN, had advanced age of diagnosis, or prolonged time to PRL normalization.

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多巴胺受体激动剂治疗的高泌乳素血症患者患乳腺癌的风险。
目的:鉴于催乳素(PRL)在乳腺组织中的多方面作用,人们假设高催乳素血症与乳腺癌之间存在关联。尽管之前的研究并未发现这种风险,但我们仍希望调查两者之间是否存在联系:这项回顾性队列研究比较了多巴胺受体激动剂(DA)治疗的高泌乳素血症患者与匹配对照组的乳腺癌发病率,两者的比例为 1:5。主要结果是确诊高泌乳素血症后的乳腺癌诊断结果:研究对象包括1484名经DA治疗的高泌乳素血症女性患者和7418名女性对照组患者(诊断时平均年龄为32.70 ± 11.12岁;体重指数为25.60 ± 5.84 kg/m2)。27名高泌乳素血症患者(1.82%)和97名对照组患者(1.31%)被确诊为乳腺癌(HR 1.40,95% CI 0.91-2.14,P = 0.12)。与未患乳腺癌的患者相比,患乳腺癌的患者被诊断出患有高泌乳素血症的时间较晚(中位年龄为 42.63 岁对 29.79 岁;P 结论:高泌乳素血症患者的中位年龄为 42.63 岁对 29.79 岁:总体而言,与对照组相比,经 DA 治疗的高催乳素血症患者罹患乳腺癌的风险并没有增加。但是,PRL 水平达到中位数的患者罹患乳腺癌的风险明显较高。
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来源期刊
Journal of Endocrinological Investigation
Journal of Endocrinological Investigation ENDOCRINOLOGY & METABOLISM-
CiteScore
8.10
自引率
7.40%
发文量
242
期刊介绍: The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.
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