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Web End = Cancer Causes Control (2015) 26:12891297
DOI 10.1007/s10552-015-0622-4
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Web End = 5-a reductase inhibitors, benign prostatic hyperplasia, and risk of male breast cancer
David Robinson1,2 Hans Garmo3,4 Lars Holmberg3,4 Par Stattin1
Received: 25 December 2014 / Accepted: 13 June 2015 / Published online: 25 June 2015 The Author(s) 2015. This article is published with open access at Springerlink.com
AbstractPurpose 5-a reductase inhibitors (5-ARI) have been suggested to increase the risk of male breast cancer. The aim of this study was to study the risk of breast cancer in men on 5-ARI, in men with benign prostatic hyperplasia (BPH) not on 5-ARI, and in men without BPH.
Methods We performed a population-based cohort study in Sweden with data from The Prescribed Drug Register, The Patient Register, and The Cancer Register. Men on 5-ARI, men on a-blockers, or men who had undergone a transurethral resection of the prostate (TUR-P) prior to or during 20062008 were included as exposed to BPH and a specic treatment thereof. For each exposed man, ve unexposed men were selected. Risk of breast cancer was calculated in Cox proportional hazard models.
Results There were 124,183 exposed men and 545,293 unexposed men, and during follow-up (median 6 years), 99 men with breast cancer were diagnosed. Compared to unexposed men, men on 5-ARI had a hazard ratio (HR) of breast cancer of 0.74 (95 % condence interval (CI)0.272.03), men on a-blockers had HR 1.47 (95 % CI
0.732.95), and men with a TUR-P had HR 1.99 (95 % CI1.053.75).
Conclusion No increased risk of breast cancer was observed for men on 5-ARI. However, the increased risk of breast cancer among men who had undergone a TUR-P, a strong indicator of BPH, suggests that the endocrine milieu conducive to BPH is associated with male breast cancer.
Keywords 5-a reductase inhibitors Male breast cancer
Benign prostatic hyperplasia
Introduction
5-a reductase inhibitors (5-ARI) are commonly used for the treatment of lower urinary tract symptoms (LUTS) often caused by benign prostatic hyperplasia (BPH). The mode of action of 5-ARI is to...