A Prospective Cohort Study of Cabergoline for Inhibition of Lactation-Related Breast Symptoms After Dilation and Evacuation From 14 to 24 Weeks of Gestation

OBJECTIVE: To evaluate patient acceptance of cabergoline and efficacy in reducing breast symptoms after dilation and evacuation (D&E) from 14 to 24 weeks of gestation. METHODS: We conducted a prospective cohort study evaluating the practice of routinely offering cabergoline to patients at 14–24 weeks of gestation after D&E for any indication at an urban academic medical center. We recorded acceptance and collected demographic and clinical characteristics. We administered the Bristol Breast Symptom Inventory during a routine postoperative phone call. We compared patient demographic and clinical characteristics by cabergoline and intake using χ 2 and t tests. We evaluated the association between cabergoline acceptance and intake with presence of breast symptoms using the Fisher exact test. We used Stata BE18.0. RESULTS: Of 144 sequential patients offered cabergoline from July 21, 2023, to October 18, 2024, 134 (93.1%) accepted and 124 (86.1%) took cabergoline. We obtained breast symptom data for 119 patients (82.6%) at a mean 3.5 days postoperatively. Demographic and clinical characteristics were similar except for ethnicity, with non-Hispanic patients more likely to decline than Hispanic patients. Patients who took cabergoline were less likely to report the presence of breast symptoms compared with those who did not (26.4% vs 77.8%, risk ratio 0.35, 95% CI, 0.21–0.58, P =.001). Among non-Hispanic patients, the association between cabergoline intake and lower incidence of breast symptoms remained (31.6% vs 87.5%, P =.004). In the overall population, regardless of cabergoline use, there was no association between gestational age and presence of breast symptoms. Among the 44 patients at less than 18 weeks of gestation, 16.6% of those who took cabergoline and 100% of those who did not take cabergoline reported breast symptoms. CONCLUSION: Routinely offering cabergoline was frequently accepted by patients after D&E. Cabergoline intake was associated with lower incidence of breast symptoms. Our results are limited by the small number who declined cabergoline. Our findings support the use of cabergoline among patients after D&E from 14 to 24 weeks of gestation.