Antibiotics and Breast Cancer—What's the Meaning of This?

Abstract

See also p 827.

Exploring infections as an aetiological agent of breast carcinoma

“…Other studies however are trying to explore the other side of the story; can bacterial infections confer protection from the development of breast cancer? One finding that may support this study showed that chronic antibiotic use increased the risk of breast cancer [44]. Another study concluded that the IL-10 feedback inhibitory loop which is important for inhibition and therefore regulation of immune homeostasis is lost due to improved personal hygiene and antibiotic use.…”

After the Antibiotics and Breast Cancer Study: What to Tell Patients

“…After all, the findings of the article are inconclusive, there are too many limitations, and there are serious drawbacks in this study. An editorial comment on the article points out that “this study provides many (or more) questions than answers.” 7 Even more important, as the authors of the article themselves mentioned several times in their text, “it cannot be determined from this study whether the use of antibiotics is causally related to breast cancer or whether the indication for antibiotic use, overall weakened immune function, or other factors are the pertinent underlying exposures.” In other words, this study proves a casual, but in no way causal, relationship between antimicrobials and breast cancer. With insufficient hard evidence to justify antibiotic restriction and avoidance from acne patients, we hear the echoes of the unresolved debates on coffee; fluoridated water; and the artificial sweeteners saccharin, cyclamate, and aspartame as causes of cancer.…”

“…Recommendations such as, “These findings reinforce the need for prudent long‐term use of antibiotics” 5 from the study, “Carefully select patients for chronic antibiotic therapy” and “proper use of these drugs” from the AAD member alert, or “Use wisely,” or “caution in the use of antibiotics” from the editorial comment to the study 7 are sensible but of limited help. In contrast, guidelines like, “Limit long‐term use (of antibiotics) to those patients without other alternatives” (from the AAD member alert) make more sense and May facilitate decision making.…”

Antibiotic issues in dermatology

“…it cannot be determined from this study whether antibiotic use is causally related to breast cancer, or whether indication for use, overall weakened immune function, or other factors are pertinent underlying exposures.'' 2 Ness and Cauley, 3 in the JAMA editorial discussing this manuscript, asserted that confounding is a major limitation of case control studies. ''Confounding by indication occurs if women using antibiotics differ from nonusers in ways that elevate their breast cancer risk.…”