ReviewBreast cancer research and treatment2019
Safety of 5α-reductase inhibitors and spironolactone in breast cancer patients receiving endocrine therapies.
Review in Breast cancer research and treatment, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Sexual dysfunction associated with 5α-reductase inhibitors in the treatment of androgenetic alopecia: a systematic review.Frontiers in medicine · 2026Pooled it
- Androgenetic Alopecia in Women: A Narrative Review of Pathophysiology, Clinical Evaluation, and Treatments.American journal of clinical dermatology · 2026Review
- The use of oral dutasteride, minoxidil, and finasteride for treating endocrine therapy-induced hair loss from breast cancer treatment: A case series study.JAAD case reports · 2026Article
- Mechanism of intermittent dosing of fluoxetine in premenstrual dysphoric disorder.Archives of women's mental health · 2025Review
- Safety of Alopecia Treatments in Patients with Breast Cancer and High-Risk Women: A Review.American journal of clinical dermatology · 2025Review
- Approaches to management of endocrine therapy-induced alopecia in breast cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Review
- Risk of estrogen-driven malignancies in females on 5-alpha reductase inhibitors.Archives of dermatological research · 2024Article
- Safety of Antiandrogens for the Treatment of Female Androgenetic Alopecia with Respect to Gynecologic Malignancies.Journal of clinical medicine · 2024Review
- The Hormonal Background of Hair Loss in Non-Scarring Alopecias.Biomedicines · 2024Review
- Several first-line anti-hypertensives act on fibrosarcoma progression and PD1ab blockade therapy.Journal of orthopaedic surgery and research · 2024Article
- Retrospective cohort study of CDK4/6-inhibitor-induced alopecia in breast cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- COVID-19 therapeutics: Clinical application of repurposed drugs and futuristic strategies for target-based drug discovery.Genes & diseases · 2023Review
- Prevention and Treatment of Chemotherapy-Induced Alopecia: What Is Available and What Is Coming?Current oncology (Toronto, Ont.) · 2023Review
- Challenges in treatment of patients with non-classic congenital adrenal hyperplasia.Frontiers in endocrinology · 2022Review
- Review
- Restorative oncodermatology: Diagnosis and management of dermatologic sequelae from cancer therapies.Journal of the American Academy of Dermatology · 2021Review
- Drug Repurposing Approach, Potential Drugs, and Novel Drug Targets for COVID-19 Treatment.Journal of environmental and public health · 2021Review
- Prevention, Detection, and Management of Heart Failure in Patients Treated for Breast Cancer.Current heart failure reports · 2020Review
- Repurposing existing drugs for COVID-19: an endocrinology perspective.BMC endocrine disorders · 2020Article
- Dermatologic conditions in women receiving systemic cancer therapy.International journal of women's dermatology · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
purposeTo provide dermatologists and oncologists with a foundation for practical understanding and uses of 5α-reductase inhibitors and spironolactone for breast cancer patients and survivors receiving endocrine therapies (ETs), including the effect of these treatments on sex hormone levels, any reported drug interactions, and any risk of malignancy.
methodsAll published studies from January 1978 through April 2018 were considered, using databases such as PubMed, Google Scholar, and Science Direct. Forty-seven studies were included in this review.
resultsThere is no evidence of interactions between 5α-reductase inhibitors and spironolactone with ETs used in breast cancer. Sex hormone alteration with 5α-reductase inhibitor or spironolactone use is variable. Three randomized controlled trials, 1 case-control study, and 6 retrospective cohort studies, including 284 female patients, studied the effects of 5α-reductase inhibitors on serum estrogen levels. Levels were increased in 97 of 284 (34%) patients, decreased in 15 of 284 (5.3%) patients, and unchanged in 162 of 284 (57%) patients. Four retrospective cohort studies, 1 case study, and 1 double-blinded crossover study, including 95 female patients, assessed the effect of spironolactone on estrogen levels. Levels were increased in 25 of 95 (26%) patients, decreased in 6 of 95 (6.3%) patients, and unchanged in 64 of 95 (67%) patients. Ultimately, most patients did not have a significant alteration in the level of estrogen when using 5α-reductase inhibitors or spironolactone. No consistent evidence of increased risk of female breast cancer while on spironolactone was reported in 3 studies including 49,298 patients; the risk of breast cancer with the use of 5α-reductase inhibitors has not been studied.
conclusionsMost patients did not show increased estrogen levels with spironolactone and there were no data suggesting increased risk of breast cancer. Based on hormonal and pharmacological activity, spironolactone may be considered for further research on alopecia and hirsutism in breast cancer patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.