Analysis of Data From Breast Diseases Treated With 5-Alpha Reductase Inhibitors for Benign Prostatic Hyperplasia

In a meta-analysis of 14 studies involving 37,851 patients, the use of 5-alpha reductase inhibitors (5ARIs) like dutasteride and finasteride for treating benign prostatic hyperplasia was associated with a significantly increased risk of gynecomastia and breast tenderness compared to placebo and alpha-blocker monotherapy. The risk of gynecomastia was 1.79 times higher with 5ARIs than placebo, and the risk of breast tenderness was 2.85 times higher. Combination therapy with 5ARIs and alpha-blockers also showed a higher prevalence of breast tenderness compared to alpha-blockers alone. However, the study did not find a significant increase in the risk of breast cancer associated with 5ARIs use. Despite the effectiveness of 5ARIs in treating BPH symptoms, the increased risk of breast-related side effects was a concern, with dutasteride potentially causing more cases of gynecomastia than finasteride. Further research was suggested to confirm the long-term risk of breast cancer with 5ARIs use.