Adiposity and sex hormones in postmenopausal breast cancer survivors.
OBJECTIVE
Overweight and obese women with breast cancer have poorer survival compared with thinner women. One possible reason is that breast cancer survivors with higher degrees of adiposity have higher concentrations of tumor-promoting hormones. This study examined the association between adiposity and concentrations of estrogens, androgens, and sex hormone-binding globulin (SHBG) in a population-based sample of postmenopausal women with breast cancer.


METHODS
We studied the associations between body mass index (BMI), body fat mass, and percent body fat, measured by dual-energy x-ray absorptiometry scan, waist circumference, and waist-to-hip circumference ratio, with concentrations of estrone, estradiol, testosterone, SHBG, dehydroepiandrosterone sulfate, free estradiol, and free testosterone in 505 postmenopausal women in western Washington and New Mexico with incident stage 0 to IIIA breast cancer. Blood and adiposity measurements were performed between 4 and 12 months after diagnosis.


RESULTS
Obese women (BMI > or = 30) had 35% higher concentrations of estrone and 130% higher concentrations of estradiol compared with lighter-weight women (BMI < 22.0; P =.005 and.002, respectively). Similar associations were observed for body fat mass, percent body fat, and waist circumference. Testosterone concentrations also increased with increasing levels of adiposity (P =.0001). Concentrations of free estradiol and free testosterone were two to three times greater in overweight and obese women compared with lighter-weight women (P =.0001).


CONCLUSIONS
These data provide information about potential hormonal explanations for the association between adiposity and breast cancer prognosis. These sex hormones may be useful biomarkers for weight loss intervention studies in women with breast cancer.
Cancer Prevention Research Program, MP-900, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA. amctiern@fhcrc.org
Anne
A
McTiernan
Kumar B
KB
Rajan
Shelley S
SS
Tworoger
Melinda
M
Irwin
Leslie
L
Bernstein
Richard
R
Baumgartner
Frank
F
Gilliland
Frank Z
FZ
Stanczyk
Yutaka
Y
Yasui
Rachel
R
Ballard-Barbash
D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000502:physiology*; D000886:Anthropometry; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood; D004970:Estrone / Q000097:blood; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009516:New Mexico / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D017698:Postmenopause; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D011795:Surveys and Questionnaires; D017741:Survivors; D013739:Testosterone / Q000097:blood; D014861:Washington / Q000453:epidemiology
D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D004970:Estrone; D013739:Testosterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate