5-alpha Reductase inhibitors and risk of male breast cancer: a systematic review and meta-analysis

Abstract

Objective:To assess the relationship between 5α-reductase inhibitors (5ARIs) and the risk of male breast cancer (MBC).Material and Methods:We systematically searched Medline via PubMed, Embase and the Cochrane Library Central Register up to May 2017 to identify published articles related to 5ARIs and the risk of MBC.Results:Summary effect estimates were calculated by a random-effect model, and tests for multivariable-unadjusted pooled risk ratios (RR) and heterogeneity, as well as the sensitivity analyses were conducted to assess publication bias. All four studies were conducted in a quality assessment according to the Newcastle Ottawa Scale system. The strength of association between 5ARIs and the prevalence of MBC was evaluated by using summarized unadjusted pooled RR with a 95% confidence interval [CI]. Four studies involving 595.776 participants, mean age range from 60 to 73.2 years old, were included in a meta-analysis, which produced a summary unadjusted RR of the risk of MBC for the treatment of 5ARIs of 1.16 (95% CI 0.85-1.58, P=0.36) and the multivariable-adjusted RR is 1.03, (95% CI 0.75-1.41, p=0.86). There was no heterogeneity among included studies (I2=0%, P=0.49). Estimates of total effects were generally consistent with the sensitivity.Conclusion:We did not observe a positive association between the use of 5ARIs and MBC. The small number of breast cancer cases exposed to 5ARIs and the lack of an association in our study suggest that the development of breast cancer should not influence the prescribing of 5ARIs therapy.

<p>Dihydrotestosterone Induces Proliferation, Migration, and Invasion of Human Glioblastoma Cell Lines</p>

“… 37 – 42 In this regard, we have demonstrated that flutamide, an AR antagonist can block the effects of T on proliferation, migration, and invasion of cells derived from human GBM. 18 Although effectiveness of 5αR inhibitors in modulating androgenic alopecia has been demonstrated in both men and women, 43 and prostate cancer; 37 the consequences of its use are under study, 44 for example, in sexual function, men libido, and T levels. 45 , 46 Therefore, additional experiments are required to determine the effects of T metabolism inhibitors in the treatment of GBM.…”

5-alpha reductase inhibitors use in prostatic disease and beyond

“…Several other adverse effects have been described, including depression, cardiovascular disease, and metabolic syndrome. Suggestions of an increase in the incidence of male breast cancer and dementia have not been supported by current literature (15,16). The association of 5-ARIs and depressive symptoms was first highlighted in the Prostate Cancer Prevention Trial (PCPT) (4).…”