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The use of atypical antipsychotics and the risk of breast cancer

  • Epidemiology
  • Published:
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Abstract

To determine whether atypical antipsychotics, when compared to typical antipsychotics, increase the risk of breast cancer. We conducted a retrospective cohort study using a nested case–control analysis within the United Kingdom General Practice Research Database population. We identified all female patients prescribed at least one antipsychotic (either typical or atypical), between 1 January 1988 and 31 December 2007, with follow-up until 31 December 2010. All incident cases of breast cancer were identified and matched up to 10 controls. Adjusted rate ratios (RR) of breast cancer associated with ever use of atypical antipsychotics was compared to ever use of typical antipsychotics. The cohort included 106,362 patients prescribed antipsychotics during the study period. During a mean follow-up of 5.3 years, 1237 patients were diagnosed with breast cancer (overall rate: 2.7 per 1000/year). Compared to patients who only used typical antipsychotics, exclusive users of atypical antipsychotics were not an increased risk of breast cancer (RR: 0.81, 95% CI: 0.63, 1.05). These results remained consistent after considering specific atypical antipsychotics known to significantly increase prolactin levels such as risperidone (RR: 0.86, 95% CI: 0.60, 1.25). Furthermore, no dose–response was observed in terms of cumulative duration of use and cumulative dose in olanzapine equivalents. The results of this study should provide reassurance that compared to typical antipsychotics, atypical antipsychotics do not increase the risk of breast cancer.

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Acknowledgments

Dr. Laurent Azoulay is the recipient of a ‘Chercheur-Boursier’ Award from the Fonds de la recherche en santé du Québec. Dr. Samy Suissa is the recipient of a Distinguished Investigator Award from the Canadian Institutes of Health Research. This study was supported by a Catalyst Grant from the Canadian Institutes of Health Research.

Conflicts of interest

The authors report no conflicts of interest.

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Authors and Affiliations

  1. Centre for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital, 3755 Côte Sainte-Catherine, H-425.1, Montreal, QC, H3T 1E2, Canada

    Laurent Azoulay, Hui Yin, Christel Renoux & Samy Suissa

  2. Department of Oncology, McGill University, Montreal, QC, Canada

    Laurent Azoulay

  3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada

    Samy Suissa

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  1. Laurent Azoulay
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  2. Hui Yin
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  4. Samy Suissa
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Correspondence to Laurent Azoulay.

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Azoulay, L., Yin, H., Renoux, C. et al. The use of atypical antipsychotics and the risk of breast cancer. Breast Cancer Res Treat 129, 541–548 (2011). https://doi.org/10.1007/s10549-011-1506-2

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  • DOI: https://doi.org/10.1007/s10549-011-1506-2

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