Dopamine Antagonists and the Development of Breast Cancer

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Abstract
EACH YEAR, more than 180 000 cases of breast cancer are diagnosed and 44 000 breast cancer deaths occur in the United States alone.1 Such burdens confer high priority on the identification of modifiable risk factors, including the use of medications that may initiate or promote breast malignancies. Laboratory studies2 have raised the possibility that some centrally acting dopamine antagonists used to treat psychotic disorders may increase the risk of breast malignancies. It is well established that at therapeutic dosages, some of these drugs cause dose-dependent increases in serum prolactin levels, with significantly greater increases in women than in men given comparable doses.3 In animals, increased prolactin levels can cause malignant transformation of breast tissue.4 Elevated prolactin levels also promote tumor growth in rodents with induced mammary malignancies.5-7 The Food and Drug Administration has required product label warnings for conventional neuroleptics since the1970s based on a possible association with breast cancer.

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