男性乳腺癌与5-α还原酶抑制剂间的相关性研究：非那雄胺和度那雄胺
Male breast cancer and 5-alpha reductase inhibitors, finasteride and dutasteride
- Steven T. Bird, 1, 2,
- James M. Brophy, 3,
- Abraham G. Hartzema, 2,
- Joseph A.C. Delaney, 4,
- Mahyar Etminan, 5,
,
- 1 Department of Health and Human Services / Food and Drug Administration / Center for Drug Evaluation and Research (CDER) / Office of Pharmacovigilance and Epidemiology / Office of Surveillance and Epidemiology / Department of Epidemiology, 10903 New Hampshire Avenue, Silver Spring, MD, USA
- 2 Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, 101 S. Newell Drive (HPNP), PO Box 100496, Gainesville FL, USA
- 3 Department of Medicine, McGill University, Royal Victoria Hospital, 687 Pine Street West, Montreal, Quebec, Canada
- 4 Department of Epidemiology, School of Public Health, University of Washington, 1959 NE Pacific Street, Seattle, WA, USA
- 5 Child & Family Research Institute of British Columbia, University of British Columbia, A4-198 WS 2, 709-650 West 28 thAvenue, Vancouver, BC, Canada
- http://dx.doi.org/10.1016/j.juro.2013.04.132, How to Cite or Link Using DOI
Abstract
Purpose
To examine the association between 5-alpha-reductase inhibitors (5ARI) and male breast cancer.
Materials and Methods
Study participants were men aged 40-85 years, having prescription and medical coverage, and enrolled in the United States IMS claims-database between 2001-2009. Cases required a primary breast cancer diagnosis (ICD-9-CM 175.X) on 2 different dates and either a procedural code for a mastectomy or a lumpectomy/partial mastectomy with evidence of continuous care (radiation/chemotherapy or diagnoses in ≥2 months). Eligible controls were aged within 5 years and had duration of prior healthcare enrollment within 6 weeks. Risk set sampling selected 20 controls per case. We assessed the rate ratio (RR) for male breast cancer with 5ARI exposure using conditional logistic regression. Analyses were stratified by duration of healthcare enrollment prior to diagnosis (≥1 year, ≥2 years, and ≥3 years) each incremental 180 and 365 days of cumulative 5ARI exposure, and period-specific timeframes prior to diagnosis(years 1, 2, and 3).
Results
We identified 339 breast cancer cases matched to 6,780 controls. No statistically significant associations were observed between 5ARIs and breast cancer, regardless of exposure assessment prior to index date [≥1 year (RR 0.70 95%CI: 0.34-1.45), ≥2 years (RR 0.59 95%CI: 0.24-1.48), or ≥3 years (RR 0.75 95%CI: 0.27-2.10)]. Each subsequent 180 days [RR 1.02 95%CI: 0.67-1.53] and 365 days [RR 1.03 95%CI: 0.45-2.37] of cumulative 5ARI therapy and period-specific RRs also observed null associations.
Conclusions
The lack of an association in our study suggests breast cancer development should not influence prescribing of 5ARI therapy.
Keywords
- Male Breast Cancer;
- 5-alpha reductase inhibitors
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