Wednesday, March 7, 2018

Women With Schizophrenia May Be at Greater Risk of Breast Cancer, Meta-Analysis Finds

Women with schizophrenia may be at a 30% higher risk of breast cancer than women without schizophrenia, according to a meta-analysis published today in JAMA Psychiatry.

“Because breast cancer is the most common cancer in women, affecting 1 in 9 women during their lifetime, our findings highlight that intensive prevention and treatment against breast cancer are warranted for women with schizophrenia,” wrote study authors Chuanjun Zhuo, M.D., Ph.D., of Tianjin Medical University in China and Patrick Todd Triplett, M.D., of Johns Hopkins School of Medicine.

Zhuo and Triplett conducted a systematic search of PubMed and EMBASE databases; twelve cohort studies that included 125,760 women were included in the meta-analysis. The number of women with schizophrenia included in each study varied from 1,388 to 46,447, and the number of the breast cancer cases ranged from 42 to 1,042.

The meta-analysis revealed that schizophrenia was associated with a significantly increased risk of breast cancer incidence in women (standardized incidence ratio, 1.31); however, there were significant differences between the studies included in the meta-analysis.

“Future studies are needed to determine the association between schizophrenia and the different pathologic subtypes of breast cancer as well as whether the association may be affected by the woman’s age at breast cancer onset, antipsychotic medications used, and the cancer subtype,” Zhuo and Triplett wrote.

Despite the limitations of the meta-analysis, the authors noted the results indicate that women with schizophrenia deserve focused care for breast cancer screening and treatment.

“For the early prevention of breast cancer, an initial evaluation is needed to stratify the risk of breast cancer in women with schizophrenia. Subsequently, antipsychotics that may increase the prolactin level and produce a higher breast cancer risk should be avoided in high-risk women. Regular screening, including imaging or biomarker tests, should be performed. If an early diagnosis of breast cancer is made in women with schizophrenia, collaborations with oncologists are needed for clinical psychiatrists to make an optimal treatment recommendation,” they wrote.

For related information, see the Psychiatric News PsychoPharm article “Expert’s Corner: Best Practices for Treating Cancer Patients With Psychiatric Symptoms,” by Philip Bialer, M.D., of Memorial Sloan Kettering Cancer Center and the Psychiatric Services article “Mammography Among Women With Severe Mental Illness: Exploring Disparities Through a Large Retrospective Cohort Study.”

(Image: iStock/Ridofranz)


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