title: Circulating sex hormones and tumor characteristics in postmenopausal breast cancer patients. A cross-sectional study.
abstract: BACKGROUND
  To further investigate the role of sex hormones in breast cancer, we assessed the relations of circulating estradiol and testosterone to tumor size and estrogen receptor (ER) status.
  
  
  METHODS
  This was a cross-sectional study including 492 postmenopausal breast cancer patients. The relation of circulating hormones to patient and tumor characteristics was assessed using the Fisher or Cuzick tests. Multivariable logistic regression was used to estimate the odds ratios (ORs) of having tumors =2 cm (vs and <2 cm) and having ER-positive tumors (vs ER-negative) with increasing quartiles of estradiol and testosterone.
  
  
  RESULTS
  Mean estradiol and testosterone levels increased significantly with increasing tumor size. The ORs of tumors =2 cm increased significantly with increasing quartiles of estradiol (Ptrend and <0.001) and testosterone (Ptrend=0.005). When adjusted for estradiol, the association between testosterone and tumor size was no longer significant. Mean testosterone levels were higher in ER-positive than ER-negative patients (p and <0.001), while mean estradiol levels did not differ significantly between the two ER categories (p=0.192). The ORs of having an ER-positive tumor increased significantly with increasing quartiles of testosterone (Ptrend=0.002), whereas the increase with increasing estradiol quartiles was not significant (Ptrend=0.07).
  
  
  CONCLUSIONS
  The association of both hormones with tumor size implies that both are involved in tumor growth, testosterone mainly by conversion to estradiol. The strong association of testosterone with ER contrasts with the weak association of estradiol with ER and confirms testosterone as a marker of hormone-dependent tumors. These findings suggest that testosterone evaluation might be useful to better identify patients with hormone-dependent disease.
authors.affiliation: Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy. giorgio.secreto@istitutotumori.mi.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Secreto
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Meneghini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Venturelli
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cogliati
authors.forename: Roberto
authors.initials: R
authors.lastname: Agresti
authors.forename: Cristina
authors.initials: C
authors.lastname: Ferraris
authors.forename: Massimo
authors.initials: M
authors.lastname: Gion
authors.forename: Matelda
authors.initials: M
authors.lastname: Zancan
authors.forename: Aline S C
authors.initials: AS
authors.lastname: Fabricio
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
authors.forename: Adalberto
authors.initials: A
authors.lastname: Cavalleri
authors.forename: Andrea
authors.initials: A
authors.lastname: Micheli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood; D011960:Receptors, Estrogen / Q000097:blood*; D011980:Receptors, Progesterone / Q000097:blood*; D013739:Testosterone / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D012739:Gonadal Steroid Hormones; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D013739:Testosterone