Preventing breast cancer in women with schizophrenia.
OBJECTIVE
To record risk factors for breast cancer in women with schizophrenia and recommend preventive actions.


METHODS
A PubMed literature search (from 2005 to 2010) was conducted, using the search terms 'schizophrenia', 'antipsychotics', 'breast cancer' and 'risk factors'.


RESULTS
Several risk factors of relevance to schizophrenia were identified: obesity, elevated prolactin levels, low participation in mammography screening, high prevalence of diabetes, comparatively low parity, low incidence of breastfeeding, social disadvantage, high levels of smoking and alcohol consumption, low activity levels.


CONCLUSIONS
Awareness of breast cancer risk should lead to more accurate risk ascertainment, stronger linkage with primary care, regular monitoring and screening, judicious choice and low dose of antipsychotic treatment, concomitant use of adjunctive cognitive and psychosocial therapies, referral to diet and exercise programmes as well as smoking and drinking cessation programmes, avoidance of hormonal treatment and discussion with patient and family about the pros and cons of preventive measures in high-risk women. Psychiatrists are in a position to reverse many of the identified risk factors.
Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada. mary.seeman@utoronto.ca
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D000428:Alcohol Drinking / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D015444:Exercise; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications; D009765:Obesity / Q000150:complications; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications*; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors
D000928:Antidepressive Agents