Breast Cancer Risk Among Users of Antidepressant Medications

Centro Español de Investigación Farmacoepidemiológica (CEIFE), Madrid, Spain.
Epidemiology (Impact Factor: 6.2). 02/2005; 16(1):101-5. DOI: 10.1097/01.ede.0000147103.92638.c0
Source: PubMed


Breast cancer is the most common cancer in women. Laboratory studies suggest that antidepressants may promote breast cancer tumor growth. Several epidemiologic studies have evaluated this association with conflicting results.
We conducted a cohort study with a secondary nested case-control analysis based on the General Practice Research Database. Our goal was to assess the association between the risk of breast cancer and use of serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and other antidepressants. We calculated adjusted estimates controlling for breast cancer risk factors using unconditional logistic regression.
A total of 3708 cases of breast cancer were ascertained. Overall, antidepressant use was not associated with an increased risk of breast cancer. Current users of SSRIs had an odds ratio (OR) of 0.98 (95% confidence interval=0.81-1.19), whereas current users of TCAs had an OR of 0.86 (0.73-1.00). When only use for longer than 1 year was considered, the corresponding estimates for SSRIs and TCAs were 0.76 (0.53-1.09) and 0.87 (0.70-1.09), respectively. None of the individual drugs was associated with breast cancer risk.
Use of antidepressants was not associated with an increased risk of breast cancer regardless of duration of use, daily dose, or specific drug being used. These results, together with evidence from prior studies, support the lack of a clinically meaningful association between breast cancer risk and antidepressants.

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Available from: Luis Alberto Garcia-Rodriguez
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    • "In our study, age 55 was chosen as a cut-off to avoid misclassification of premenopausal cases as post-menopausal, since breast cancer cases are more likely to self-report a later age at menopause (Morabia and Flandre, 1992; Phipps et al., 2010). In addition, previous studies investigating the role of menopausal status on breast cancer risk have used similar age cut-offs to define menopausal status (Van Hoften et al., 2000; Tryggvadottir et al., 2002; Gonzalez-Perez and Garcia Rodriguez, 2005). "
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    • "However, despite these methodological improvements, our results are consistent with most other observational studies, including six that used self-reported SSRI exposure information [19-24], and four studies that ascertained SSRI use from a prescription database [25-28]. However, only three of these studies [22,24,27] had sufficient sample sizes to adequately evaluate risk associated with three or more years of combined SSRI use, and only one study [27] quantified total SSRI use with a dosage variable. "
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    • "This is supported by the relation with dose (where those without depression have a higher proportion of low dose and vice versa). Previous studies have examined tricyclics and the incidence of colorectal (Xu et al, 2006), prostate (Tamim et al, 2007), breast (Cotterchio et al, 2000; Gonzalez-Perez and Garcia Rodriguez, 2005; Fulton-Kehoe et al, 2006; Wernli et al, 2009) and lung cancers (Toh et al, 2007), but have shown little consistency, and significant evidence has been found to link tricyclics with cancer. A study on colorectal cancer (Xu et al, 2006) hypothesised that tricyclics are genotoxic, and therefore increase cancer risk, but, their results suggest a nonsignificant protective effect, as did another recent study (Patricia et al, 2009). "
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