Relationship of Blood Prolactin Levels and the Risk of Subsequent Breast Cancer

Wang, D Y; Stavola, Bianca De; Bulbrook, R. D.; Allen, D S; Kwa, H. G.; Is, Fentiman; Hayward, John; Millis, R R

doi:10.1093/ije/21.2.214

Cited by 71 publications

(47 citation statements)

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“…A statistically significant higher risk of breast cancer was found in women who had PRL levels above 9.7 ng/ml (relative risk of 2.03 with a 95% CI (1.24-3.31)), even when several established breast cancer risk factors were controlled for. In another prospective study with 40 postmenopausal breast cancer patients, Wang et al found a positive but nonsignificant association between elevated PRL levels and the risk of developing breast cancer (Wang et al, 1992).…”

Section: Breast Cancermentioning

confidence: 96%

From Galactorrhea to Osteopenia: Rethinking Serotonin–Prolactin Interactions

Emiliano

Fudge

2004

Neuropsychopharmacol

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The widespread use of the selective serotonin reuptake inhibitors (SSRIs) has been accompanied by numerous reports describing a potential association with hyperprolactinemia. Antipsychotics are commonly known to elevate serum prolactin (PRL) through blockade of dopamine receptors in the pituitary. However, there is little awareness of the mechanisms by which SSRIs stimulate PRL release. Hyperprolactinemia may result in overt symptoms such as galactorrhea, which may be accompanied by impaired fertility. Long-term clinical sequelae include decreased bone density and the possibility of an increased risk of breast cancer. Through literature review, we explore the possible pathways involved in serotonin-induced PRL release. While the classic mechanism of antipsychotic-induced hyperprolactinemia directly involves dopamine cells in the tuberoinfundibular pathway, SSRIs may act on this system indirectly through GABAergic neurons. Alternate pathways involve serotonin stimulation of vasoactive intestinal peptide (VIP) and oxytocin (OT) release. We conclude with a comprehensive review of clinical sequelae associated with hyperprolactinemia, and the potential role of SSRIs in this phenomenon.

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Section: Breast Cancermentioning

confidence: 96%

From Galactorrhea to Osteopenia: Rethinking Serotonin–Prolactin Interactions

Emiliano

Fudge

2004

Neuropsychopharmacol

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“…High plasma prolactin levels were associated with a modestly increased risk of postmenopausal breast cancer [7,8]. About 95% of breast cancers expressed receptors for prolactin, meaning that they would be responsive to the stimulatory effect of prolactin [9][10][11]. However, in a study by Tworoger et al [12], a non significant positive relationship between prolactin levels and postmenopausal breast cancer was observed.…”

mentioning

confidence: 99%

Relationship between plasma progesterone, estradiol and prolactin concentrations and breast cancer in pre and postmenopausal women

Sn¹,

Atoum²,

Al-Hourani³

et al. 2010

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74Breast cancer is the second most common cancer among women after skin cancer and is the second most common cause of death among women after lung cancer. The causes of breast cancer are very complicated. Although about 7% of breast cancers are of genetical background, the rest are due to environmental causes [1]. Hormones such as estrogen, progesterone and prolactin are implicated in a number of ways as possible causes of breast cancer. Throughout women life cycle, breast development and function depend on complex critical interplay of these hormones [2]. Many breast cancers are hormone dependent, meaning hormones turn on breast cancer cell growth.Estradiol is considered the most significant breast cancer risk factor because of its direct role in stimulation breast cell division or via its effects on other hormones and due its support of the growth of estrogen-responsive tumors [2]. Although, no study has clearly demonstrated a relationship between breast cancer and estrogen levels in premenopausal women [3]. Women with high estrogen levels were more likely to go on to develop breast cancer [4]. Postmenopausal women with high plasma estrogen levels have twice the risk of developing breast cancer as women with low levels [5].Prolactin hormone is essential for breast development and lactation [6][7][8]. High plasma prolactin levels were associated with a modestly increased risk of postmenopausal breast cancer [7,8]. About 95% of breast cancers expressed receptors for prolactin, meaning that they would be responsive to the stimulatory effect of prolactin [9][10][11]. However, in a study by Tworoger et al [12], a non significant positive relationship between prolactin levels and postmenopausal breast cancer was observed. Progesterone stimulates breast development during pregnancy [13]. About 65% of estrogen positive breast Received March 31, 2009Hormones such as estrogen, progesterone and prolactin are implicated in a number of ways as possible causes of breast cancer. Throughout women life cycle, breast development and function depend on complex critical interplay of these hormones. The acknowledged gaps in our understanding concerning progesterone, estrogen and prolactin hormones involvement in human breast cancer has exposed the need to conduct this study for better understanding of the role played by these hormones in breast cancer during pre and post menopause status in order to influence prevention and treatment of breast cancer. Ninety women were enrolled, (80%) of them were breast cancer patients and the other (20%) were breast benign lesion patients. At attending King Hussein Medical Center, blood samples were collected and analyzed for plasma estradiol, prolactin and progesterone. Of the 72 breast cancer patients (66.6% and 33.4%), and of the 18 breast benign patients (27.8% and 72.2%) were in menopause and premenopausal, respectively. Of the breast cancer and benign patients groups, 55.6% of each had an association with either high plasma estradiol, prolactin or progesterone concentrations. Of the brea...

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“…1 The peptide hormone prolactin, essential in mammary development and lactation, is associated with an increased risk of breast cancer in both premenopausal 2 (Tworoger et al, 2006, submitted) and postmenopausal [3][4][5][6] women, likely through an increase in cell proliferation and inhibition of apoptosis. 7 Thus, prolactin may be one of potentially many hormonal links between reproductive risk factors and the incidence of breast cancer.…”

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confidence: 99%

Reproductive factors and family history of breast cancer in relation to plasma prolactin levels in premenopausal and postmenopausal women

Eliassen

Tworoger

Hankinson

2007

Intl Journal of Cancer

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Many reproductive factors are associated with breast cancer risk, potentially through a hormonal pathway. The peptide hormone prolactin is essential in mammary development and lactation and may be a link between risk factors and breast cancer. While higher prolactin levels are associated with increased breast cancer risk, few determinants of prolactin levels are known. We conducted a cross-sectional analysis among 1,089 premenopausal and 1,311 postmenopausal women within the Nurses' Health Study (NHS) and the NHS II to examine the associations of reproductive factors, benign breast disease and family history of breast cancer with plasma prolactin levels. Parous women had significantly lower prolactin levels than nulliparous women (parous vs. nulliparous multivariate-adjusted geometric means 5 14.1 ng/mL vs. 16.6 ng/mL, p < 0.001 for premenopausal and 9.1 vs. 10.1, p 5 0.04 for postmenopausal women), although levels did not decrease with increasing number of children for either premenopausal (p-trend 5 0.23) or postmenopausal (p-trend 5 0.07) parous women. Age at first birth was not associated with prolactin levels. The reduction in prolactin levels among parous premenopausal women appeared to attenuate with increasing time since first birth, but the trend was not statistically significant (p-trend 5 0.12). Age at menarche, duration of lactation and benign breast disease were not associated with prolactin levels. Family history of breast cancer was associated with significantly higher prolactin levels when compared with no family history among premenopausal (15.9 ng/mL vs. 14.3 ng/ mL, p 5 0.04) but not postmenopausal (p 5 0.73) women. In conclusion, the associations of parity and family history with breast cancer risk may be mediated, at least in part, by prolactin levels. ' 2006 Wiley-Liss, Inc.Key words: prolactin; reproductive factors; family history Many reproductive factors consistently associated with breast cancer risk, such as age at menarche, parity and age at first birth, likely affect risk through a hormonal pathway. 1 The peptide hormone prolactin, essential in mammary development and lactation, is associated with an increased risk of breast cancer in both premenopausal 2 (Tworoger et al., 2006, submitted) and postmenopausal 3-6 women, likely through an increase in cell proliferation and inhibition of apoptosis. 7 Thus, prolactin may be one of potentially many hormonal links between reproductive risk factors and the incidence of breast cancer. 7,8 While the association between prolactin levels and breast cancer risk is fairly consistent, whether lifestyle or reproductive factors influence prolactin levels is not well known. A number of cross-sectional studies have observed an inverse association between parity and prolactin levels in both premenopausal 9-13 and postmenopausal 9,14 women, although whether prolactin levels decline further after the first pregnancy is unclear. Other birthrelated factors, such as age at first birth, time since last birth and history of lactation, have been assessed in ...

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Relationship of Blood Prolactin Levels and the Risk of Subsequent Breast Cancer

Cited by 71 publications

References 0 publications

From Galactorrhea to Osteopenia: Rethinking Serotonin–Prolactin Interactions

From Galactorrhea to Osteopenia: Rethinking Serotonin–Prolactin Interactions

Relationship between plasma progesterone, estradiol and prolactin concentrations and breast cancer in pre and postmenopausal women

Reproductive factors and family history of breast cancer in relation to plasma prolactin levels in premenopausal and postmenopausal women

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