Antipsychotics May Heighten Breast Cancer Risk in Women with Schizophrenia
New analysis points to prolonged use and specific drug types as key factors
Women diagnosed with schizophrenia who take antipsychotic medications for extended periods face an elevated risk of developing breast cancer. A comprehensive review of studies highlights a significant link, particularly with certain types of antipsychotics and longer treatment durations.
Examining the Evidence
A review by Chittaranjan Andrade, MD, a professor at the National Institute of Mental Health and Neurosciences in Bangalore, India, analyzed multiple studies investigating the connection between antipsychotic use and breast cancer in women with schizophrenia. The findings suggest that women with schizophrenia are also less likely to undergo regular breast cancer screenings and experience higher mortality rates if diagnosed.
Specific Drug Associations
Research indicates that certain antipsychotic medications are associated with an increased risk. For instance, exposure to aripiprazole, quetiapine, olanzapine, and ziprasidone showed a hazard ratio of 1.10, while amisulpride, paliperidone, risperidone, and zotepine presented a hazard ratio of 1.29. This increased risk often became apparent after six years of treatment in one large-scale study.
Another study exploring the role of prolactin-raising medications found that antipsychotics with high prolactin-raising potential were associated with an increased risk of breast cancer when used for over one year. Conversely, prolactin-sparing antipsychotics, such as clozapine and aripiprazole, did not appear to elevate breast cancer risk, irrespective of how long they were taken.
Conflicting Findings and Nuances
While most research points to an increased risk, one study focusing on women with bipolar disorder and major depressive disorder suggested antipsychotic exposure might be protective. However, Andrade noted potential limitations in that study, including a small sample size and short exposure durations, which might explain the divergent results.
A recent 2025 study followed over 224,000 women with schizophrenia and compared them to those with other psychiatric disorders and the general population. It found a modest but statistically significant rise in new breast cancer cases among women with schizophrenia. The risk was particularly pronounced in women aged 40-64 and became significant after one year of antipsychotic treatment.
Recommendations for Clinicians and Patients
The evidence strongly suggests that women with schizophrenia, especially those on prolactin-raising antipsychotics for extended periods, require diligent breast cancer screening. Andrade emphasized the importance of prioritizing second-generation antipsychotics over first-generation ones and opting for prolactin-sparing options.
“The results of studies in the field strongly recommend that women with schizophrenia, and especially those who require prolactin-raising antipsychotic for extended periods, need to be regularly screened or otherwise monitored for the risk of breast cancer,” Andrade stated. He added, “These women comprise a vulnerable population, and their medical health should not be neglected because caring for their mental health absorbs attention and time.”
Further research is recommended to investigate the stage at which breast cancer is diagnosed in this population and to conduct studies that thoroughly account for other known breast cancer risk factors. The findings underscore the need for proactive healthcare management for women with schizophrenia. For context, breast cancer is the most common cancer among women globally, with an estimated 2.3 million new cases diagnosed worldwide in 2020, according to the World Health Organization (WHO, 2020).
