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Serum prolactin after chest wall surgery: elevated levels after mastectomy
The Journal of Clinical Endocrinology and Metabolism
|January 1, 1981
Summary
Mastectomy significantly increases prolactin (PRL) levels, potentially causing long-term hyperprolactinemia. Thoracotomy and laparotomy do not consistently affect PRL levels. This suggests a neurogenic reflex triggered by mastectomy.
Area of Science:
- Endocrinology
- Surgical Research
- Neuroendocrinology
Background:
- Galactorrhea can follow chest trauma, but prolactin (PRL) level changes are not well-documented.
- Systematic evaluation of serum PRL levels post-chest surgery is lacking.
Purpose of the Study:
- To investigate acute and chronic changes in serum PRL levels following mastectomy, thoracotomy, and laparotomy.
- To determine if mastectomy or thoracotomy leads to sustained hyperprolactinemia.
Main Methods:
- Prospective study measuring serum PRL over 5 days in patients undergoing mastectomy (10), thoracotomy (10), or laparotomy (7).
- Retrospective analysis of serum PRL levels in patients months to years after thoracotomy (31) and mastectomy (53), compared to controls (41).
Main Results:
- Mastectomy caused a significant acute rise in PRL, peaking by day 5 (35.6 ng/ml) and remaining elevated in some patients at 6 months.
- Thoracotomy and laparotomy showed no consistent PRL alterations.
- Long-term, 34% of mastectomy patients and 3% of thoracotomy patients exhibited supranormal PRL levels.
Conclusions:
- Mastectomy acutely stimulates PRL secretion, potentially leading to prolonged hyperprolactinemia.
- The observed hyperprolactinemia is likely due to neurogenic PRL release, possibly mediated by the suckling reflex.