Stage at diagnosis and breast cancer-specific mortality in breast cancer patients treated with antidepressants, anxiolytics, and antipsychotics: a population-based cohort study from Northern Ireland.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2025-08-01 Epub Date: 2025-07-05 DOI:10.1007/s10549-025-07766-8

Sarah M Baxter, Charlene M McShane, Stuart A McIntosh, Damien Bennett, Lynne Lohfeld, Daniel R S Middleton, Gerard Savage, Deirdre Fitzpatrick, Joseph Kane, Ann McBrien, David McCallion, Anna Gavin, Chris R Cardwell

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Abstract

Purpose: We examined the stage at diagnosis and breast cancer-specific mortality in a cohort of breast cancer patients prescribed medications used for mental health conditions before diagnosis.

Methods: Women newly diagnosed with breast cancer from 2011 to 2021 were identified from the Northern Ireland Cancer Registry. The primary outcome was time to breast cancer-specific mortality up to March 2023. The secondary outcomes included stage at diagnosis. We identified anxiolytic, antidepressant, and antipsychotic prescriptions dispensed in the year before breast cancer diagnosis from the Northern Ireland Enhanced Prescribing Database. Cox regression models were used to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (95%CIs) for cancer-specific mortality by use of medications.

Results: We included 13,846 women with breast cancer. In the year before breast cancer diagnosis, 31.5% were dispensed antidepressants, 12.7% anxiolytics, and 3.5% antipsychotics. The odds of late-stage disease presentation in breast cancer patients dispensed medications for mental health conditions was similar to breast cancer patients not dispensed these medications, but patients dispensed antipsychotics had higher odds of unknown stage. We found no difference in the hazard rate of breast cancer-specific mortality in patients dispensed, versus not dispensed, anxiolytics (aHR = 1.06 95%CI 0.93-1.20), a small increase in patients dispensed, versus not dispensed, antidepressants (aHR = 1.11 95%CI 1.01-1.23) and a moderate increase in patients dispensed, versus not dispensed, antipsychotics (aHR = 1.45 95%CI 1.17-1.81).

Conclusions: Breast cancer patients dispensed medications for mental health conditions were not at higher odds of presenting with late-stage disease, but patients dispensed antidepressants, and especially antipsychotics, had worse breast cancer-specific mortality.

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接受抗抑郁药、抗焦虑药和抗精神病药治疗的乳腺癌患者的诊断阶段和乳腺癌特异性死亡率：一项来自北爱尔兰的基于人群的队列研究

目的：我们研究了一组乳腺癌患者在诊断前用于心理健康状况的处方药物的诊断阶段和乳腺癌特异性死亡率。方法：从北爱尔兰癌症登记处确定2011年至2021年新诊断为乳腺癌的妇女。主要终点是到2023年3月乳腺癌特异性死亡率的时间。次要结局包括诊断时的分期。我们从北爱尔兰增强处方数据库中确定了乳腺癌诊断前一年开具的抗焦虑药、抗抑郁药和抗精神病药处方。采用Cox回归模型计算药物使用导致的癌症特异性死亡率的校正风险比（aHR）和95%置信区间（95% ci）。结果：我们纳入了13846名乳腺癌患者。在乳腺癌诊断前一年，31.5%的人服用抗抑郁药，12.7%服用抗焦虑药，3.5%服用抗精神病药。在使用精神疾病药物治疗的乳腺癌患者中，晚期疾病出现的几率与未使用这些药物的乳腺癌患者相似，但使用抗精神病药物治疗的患者出现未知阶段的几率更高。我们发现，使用抗焦虑药物的患者与未使用抗抑郁药物的患者相比，使用抗抑郁药物的患者与未使用抗抑郁药物的患者相比，使用抗精神病药物的患者的乳腺癌特异性死亡率（aHR = 1.06 95%CI 0.93-1.20）略有增加（aHR = 1.11 95%CI 1.01-1.23），使用抗精神病药物的患者与未使用抗精神病药物的患者相比，使用抗精神病药物的患者的风险率（aHR = 1.45 95%CI 1.17-1.81）略有增加。结论：使用心理健康药物治疗的乳腺癌患者出现晚期疾病的几率并不高，但使用抗抑郁药物，尤其是抗精神病药物治疗的患者乳腺癌特异性死亡率更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.