Spironolactone and Breast Cancer: Fear Not!

The document discusses the use of spironolactone, a medication traditionally used as a diuretic, for off-label treatment of conditions like acne vulgaris (AV) and androgenetic alopecia (AGA), where androgens play a role in the disease process. Despite concerns arising from animal studies suggesting a link between spironolactone and tumor development, large retrospective cohort studies have not shown an association with breast, uterine, cervical, or ovarian cancers. A systematic review also found no evidence that spironolactone interacts with endocrine therapies for breast cancer (BC) or increases the incidence of BC. A specific retrospective analysis by Wei et al. included in the document compared 123 patients with a history of BC who were prescribed spironolactone to a matched cohort without spironolactone prescriptions. The study, which had a two-year surveillance limitation, found no association between spironolactone use and increased BC recurrence (adjusted hazard ratio = 0.966). The conclusion is that spironolactone does not independently increase the risk of BC recurrence and can be considered for treating alopecia in BC survivors.