No clear link between antidepressants and breast cancer risk

Antidepressant use in general does not appear to increase the risk of breast cancer, according to a report in the May issue of Epidemiology.

“There is much that we do not understand about the causes of breast cancer, particularly in relation to environmental exposures like antidepressants and other medications,” Dr. Patricia G. Moorman from Duke University Medical Center in Durham, North Carolina told Reuters Health. “Further study of the relationship between antidepressants and breast cancer is needed, with a particular focus on the effects of long-term exposure.”Dr. Moorman and associates examined the association of antidepressant use with the risk of invasive breast cancer and of carcinoma in situ using data from the Carolina Breast Cancer and Carcinoma in situ Study, involving more than 2500 women.Their analysis is based on data from 938 cases of invasive breast cancer and 771 controls, along with 507 cases of carcinoma in situ and 455 controls.There was no evidence of increased risk of breast cancer (invasive or in situ) with any previous use of antidepressants, the authors report, and there was no consistent relation between the duration of antidepressant use and the development of breast cancer.There was a suggestion that the use of selective serotonin reuptake inhibitors (SSRIs) for at least 36 months increased the risk of invasive breast cancer, the researchers note, but there were only 13 cases and 5 controls available for this comparison.”I think it is important to keep in mind that the group of women in which there was a suggestion of an increased risk of breast cancer was quite small,” Dr. Moorman said. “Although I believe it is important to continue to monitor the relationship between exposure to antidepressants (particularly SSRIs) and breast cancer risk, it is premature to change clinical practice on the basis of this study.”Consistent with earlier studies, invasive breast cancer was more common in women with early age at menarche, nulliparity, no history of breastfeeding, family history of breast cancer, past smoking, and high waist-to-hip ratio, the report indicates. Similarly, nulliparity, family history of breast cancer, higher education level, low waist-to-hip ratio, and higher alcohol consumption were associated with a higher carcinoma in situ risk.”Based on the current state of knowledge,” Dr. Moorman concluded, “the demonstrated benefits of this class of drugs in treating depression probably outweigh the possible risk of breast cancer.”(Source: Epidemiology 2003;14:307-314: Reuters Health: Will Boggs, MD: June 17, 2003: Oncolink)