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DOI: 10.1055/s-0045-1812101
Hyperprolactinemia-Associated Bilateral Breast Uptake in Nonlactating Breasts on Radioiodine Scans with SPECT/CT Correlation: Diagnostic Pitfalls in Patients Receiving Atypical Antipsychotic Therapy
Autor*innen
Abstract
Hyperprolactinemia is a common endocrine disorder often induced by antipsychotic medications through dopaminergic inhibition. We report two nonlactating women on long-term atypical antipsychotics of risperidone with trifluperazine and olanzapine. They showed incidental bilateral breast uptake on radioiodine scans. One had markedly elevated serum prolactin; the other had high-normal levels. This finding reflects prolactin-mediated upregulation of the sodium/iodide symporter (NIS) in breast tissue, independent of lactation. Awareness of this mechanism is essential to avoid misinterpretation of radioiodine imaging as pathological uptake. These cases underscore the importance of correlating imaging findings with patient medication history and prolactin status in interpreting iodine scans.
Keywords
antipsychotics - breast iodine uptake - false positive iodine scan - hyperprolactinemia - SPECT CT - risperidone - olanzapinePublikationsverlauf
Artikel online veröffentlicht:
28. Oktober 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Hammami MM, Bakheet S. Radioiodine breast uptake in nonbreastfeeding women: clinical and scintigraphic characteristics. J Nucl Med 1996; 37 (01) 26-31
- 2 Hu LH, Wang SJ, Liu RS. Hyperprolactinemia-related 131I uptake in nonlactating breasts. Clin Nucl Med 2012; 37 (03) e57-e58
- 3 Kamberi I, Li D, McNeill A. Trends and causes of hyperprolactinemia in a Scottish cohort. Endocr Connect 2016; 5: 93-101
- 4 Peveler RC, Branford D, Citrome L. et al. Antipsychotics and hyperprolactinaemia: clinical recommendations. J Psychopharmacol 2008; 22 (02) 98-103
- 5 Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs 2004; 64 (20) 2291-2314
- 6 Takeuchi H, Suzuki T, Remington G, Uchida H. Antipsychotic-induced hyperprolactinemia: pathophysiology and clinical consequences. CNS Drugs 2010; 24: 561-576
- 7 Yoon YB, Um YH, Sohn IK. Adjunctive aripiprazole for antipsychotic-induced hyperprolactinemia. Clin Psychopharmacol Neurosci 2016; 14: 354-362
- 8 Molitch ME. Evaluation and treatment of hyperprolactinemia. J Clin Endocrinol Metab 2023; 108: 1-12
- 9 Melmed S, Kaiser UB, Lopes MB. et al. Clinical biology of the pituitary adenoma. Endocr Rev 2022; 43 (06) 1003-1037
- 10 Tazebay UH, Wapnir IL, Levy O. et al. The mammary gland iodide transporter is expressed during lactation and in breast cancer. Nat Med 2000; 6 (08) 871-878
- 11 Wapnir IL, van de Rijn M, Nowels K. et al. Immunohistochemical profile of the sodium/iodide symporter in thyroid, breast, and other carcinomas using high density tissue microarrays and conventional sections. J Clin Endocrinol Metab 2003; 88 (04) 1880-1888
- 12 Ronga G, Bruno R, Puxeddu E. et al. Radioiodine uptake in non-lactating mammary glands: evidence for a causative role of hyperprolactinemia. Thyroid 2007; 17 (04) 363-366