Does Spironolactone Increase the Risk of Breast Cancer in Older Women?

Globally, breast cancer accounts for 22 percent of all types of cancers occurring in women. In the year 2008, 456,503 deaths occurred due to breast cancer.

Spironolactone is not associated with an increased risk for breast cancer in older women, according to a recent study.

Breast cancer is a leading cause of death in women the world over. Treatment includes chemotherapy, radiation, hormone therapy, surgery and immunotherapy.

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Isla Mackenzie and colleagues conducted a cohort study that was published in BMJ, 2012, evaluating the risk of breast cancer in older women exposed to spironolactone. Spironolactone is a potassium-sparing diuretic used in a number of conditions like fluid retention, hypertension, low potassium levels and heart failure. It acts as an aldosterone antagonist (a hormone produced by the adrenal gland), and hence is useful in a condition called hyperaldosteronism. It has progestogenic and anti-androgenic properties and therefore could contribute to promoting breast cancer.

For the purpose of study, around 1 290 625 female volunteers aged 55 years or above without any previous history of breast cancer were enrolled. A volunteer was regarded as exposed to spironolactone if she received two prescriptions of the drug after the age of 55 years.

Two unexposed randomly selected women served as controls for every woman exposed to spironolactone in the study. Among the 28,032 females exposed to spironolactone and 55,961 not exposed women, about 29,491new cases of breast cancer were reported.

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It was observed that the unadjusted rate of breast cancer was 0.39 percent per year for females exposed to spironolactone against 0.38 percent per year for non-exposed females.

In the women exposed to spironolactone, the prevalence of co-morbid heart failure and diabetes was also high. Risk factors associate with breast cancer in the study population included family history of breast cancer, exposure to multiple drug classes, history of other cancers and exposure to steroids. The scientists were of the opinion that there was no significant evidence to confirm that spironolactone increases the prevalence of breast cancer in females over the age of 55 years without any prior history of the disease. Moreover, no association was noticed between the dose of spironolactone and the risk of breast cancer.

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Reference:

Spironolactone and risk of incident breast cancer in women older than 55 years: retrospective, matched cohort study; Isla Mackenzie et al; BMJ 2012;345:e4447

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Breast cancer is the most commonly diagnosed cancer in women and in 2020 and nearly 2.3 million breast cancers were diagnosed globally.

Source-Medindia