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Prolactin and Breast Cancer Etiology: An Epidemiologic Perspective

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Journal of Mammary Gland Biology and Neoplasia Aims and scope Submit manuscript

Abstract

A number of epidemiologic studies of prolactin and breast cancer etiology have recently become available. Retrospective case-control studies have suggested a modest positive or null relationship between circulating prolactin concentrations and risk of breast cancer. However these studies are limited by small sample sizes and the collection of blood after case diagnosis. Several large prospective studies, in which blood was collected prior to diagnosis, have observed modest positive associations between prolactin and risk. In a pooled analysis of ~80% of the world’s prospective data, the relative risk (RR) comparing women in the top vs bottom quartile of prolactin levels was 1.3 (95% confidence interval (CI): 1.1, 1.6, p-trend = 0.002). The results were similar for premenopausal and postmenopausal women. Most notably, high prolactin levels were associated with a 60% increased risk of estrogen receptor (ER) positive tumors, but not with ER negative tumors. Limited genetic data suggest a role of polymorphisms in the prolactin and prolactin receptor genes in risk of breast cancer. Studies of survival have suggested that high pretreatment prolactin levels were associated with treatment failure, earlier recurrence, and worse overall survival. Parity and certain medications are the only confirmed factors associated with prolactin levels in women. Overall, epidemiologic data suggest that prolactin is involved in breast cancer etiology. Further research to better elucidate these associations and their underlying mechanisms is warranted.

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Abbreviations

RR:

relative risk

CI:

confidence interval

ER:

estrogen receptor

NHS:

Nurses’ Health Study

NHSII:

Nurses’ Health Study II

premeno:

premenopausal

postmeno:

postmenopausal

PR:

progesterone receptor

SNP:

single nucleotide polymorphism

IGF:

insulin-like growth factor

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Acknowledgment

Support for this project was from NIH grants P01 CA87969, CA49449, and CA119139.

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  1. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Shelley S. Tworoger & Susan E. Hankinson

  2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Shelley S. Tworoger & Susan E. Hankinson

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  1. Shelley S. Tworoger
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Correspondence to Shelley S. Tworoger.

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Tworoger, S.S., Hankinson, S.E. Prolactin and Breast Cancer Etiology: An Epidemiologic Perspective. J Mammary Gland Biol Neoplasia 13, 41–53 (2008). https://doi.org/10.1007/s10911-008-9063-y

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