Chubak Jessica, Bowles Erin J A, Terry Mary Beth, Trentham-Dietz Amy, Buist Diana S M
Group Health Center for Health Studies, Seattle, WA 98101-1448, USA.
Cancer Epidemiol Biomarkers Prev. 2009 Feb;18(2):676-9. doi: 10.1158/1055-9965.EPI-08-1017. Epub 2009 Feb 3.
Several studies suggest antidepressant medications can increase prolactin levels. Some, but not all, studies suggest prolactin levels are positively associated with mammographic breast density, an established risk factor for breast cancer.
We evaluated 29,284 women with two routine screening mammograms 9 to 28 months apart between 1996 to 2006 to examine whether antidepressant use was associated with changes in mammographic breast density. Mammographic breast density was assigned by radiologists and coded according the Breast Imaging Reporting and Data System classification. Exposure to antidepressants was ascertained based on electronic pharmacy dispensing data, including dispensings from claims data. We used polytomous logistic regression to estimate the odds of an increase or decrease in density categories between mammograms associated with antidepressant initiation, continuation, and discontinuation compared with nonusers of any antidepressants.
Initiation, continuation, and discontinuation of antidepressant medications were not associated with changes in mammographic density.
The lack of association between antidepressant use and breast density is consistent with recent studies that do not suggest an association between antidepressant use and breast cancer risk.
多项研究表明，抗抑郁药物可使催乳素水平升高。一些（而非全部）研究表明，催乳素水平与乳腺钼靶密度呈正相关，而乳腺钼靶密度是已确定的乳腺癌风险因素。
我们评估了1996年至2006年间29284名女性，她们接受了两次间隔9至28个月的常规乳腺钼靶筛查，以研究使用抗抑郁药物是否与乳腺钼靶密度变化相关。乳腺钼靶密度由放射科医生确定，并根据乳腺影像报告和数据系统分类进行编码。通过电子药房配药数据（包括索赔数据中的配药情况）确定抗抑郁药物的使用情况。我们使用多分类逻辑回归来估计与未使用任何抗抑郁药物的女性相比，开始、持续和停用抗抑郁药物与两次乳腺钼靶检查之间密度类别增加或减少的几率。
开始、持续和停用抗抑郁药物与乳腺钼靶密度变化无关。
使用抗抑郁药物与乳腺密度之间缺乏关联，这与近期那些未表明使用抗抑郁药物与乳腺癌风险存在关联的研究结果一致。
