SSRIs and Mammoplasia

Ms. A, a 43-year-old woman with a history of dysthymia and major depression, had a normal baseline mammogram at age 35 and a normal repeat mammogram at age 40. There was no history of fibrocystic disease. Her menstrual periods were regular. She had gained approximately 6 lb and had subjective breast enlargement as a result of fluvoxamine therapy. Approximately 8 months after starting to take fluvoxamine, 50–100 mg/day, she had another routine mammogram.

The mammogram was interpreted as having “bilateral hyperdensities,” and Ms. A was referred to a breast surgeon for consultation. No masses were found during palpation, and a 6-month follow-up mammogram was recommended. Ms. A chose to stop taking fluvoxamine because of concern that the mammoplasia and mammographic changes were related. A non-SSRI antidepressant was substituted, and her breasts returned to normal size. A 6-month follow-up mammogram was normal.