Dery Laura, Shimon Ilan, Rudman Yaron, Iraqi Hiba Masri, Kushnir Shiri, Shochat Tzipora, Cooper Odelia, Akirov Amit
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, 49100, Israel.
J Endocrinol Invest. 2025 Mar;48(3):691-699. doi: 10.1007/s40618-024-02492-2. Epub 2024 Oct 30.
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.
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.
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/m). 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).
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.
鉴于催乳素（PRL）在乳腺组织中具有多方面作用，有人提出高催乳素血症与乳腺癌之间存在关联。尽管先前的研究未发现这种风险，但我们旨在调查两者之间是否存在联系。
这项回顾性队列研究将接受多巴胺激动剂（DA）治疗的高催乳素血症患者与匹配的对照组按1:5的比例进行乳腺癌发病率比较。主要结局是高催乳素血症诊断后发生的乳腺癌诊断。
该队列由1484例接受DA治疗的高催乳素血症女性患者组成，与7418例女性对照组匹配（诊断时平均年龄32.70±11.12岁；体重指数25.60±5.84kg/m）。27例高催乳素血症患者（1.82%）和97例对照组患者（1.31%）被诊断为乳腺癌（风险比1.40，95%置信区间0.91 - 2.14，p = 0.12）。患乳腺癌的患者比未患乳腺癌的患者在生命后期被诊断为高催乳素血症（中位年龄42.63岁对29.79岁；p < 0.0001）。诊断时PRL<正常上限（ULN）5倍的患者患乳腺癌的比例高于对照组（2.25%对1.33%；风险比1.73，95%置信区间1.09 - 2.75），但PRL≥5×ULN的患者差异不显著。PRL恢复正常所需时间较长的患者乳腺癌发病率较高（未患乳腺癌者中位数为2.60年对1.41年；p = 0.03）。
总体而言，接受DA治疗的高催乳素血症患者与对照组相比，未显示出患乳腺癌的风险增加。然而，PRL水平<5×ULN、诊断时年龄较大或PRL恢复正常所需时间较长的患者风险显著更高。
