title: Serum estrone concentration, estrone sulfate/estrone ratio and BMI are associated with human epidermal growth factor receptor 2 and progesterone receptor status in postmenopausal primary breast cancer patients suffering invasive ductal carcinoma.
abstract: BACKGROUND
  We investigated in postmenopausal women with primary breast cancer prior to surgical intervention whether, serum levels of different steroid hormones and hormonal precursors associated with tumor tissue estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status.
  
  
  METHODS
  We enrolled 1,042 patients suffering invasive ductal carcinoma undergoing surgical resection in the National Institute of Oncology, Hungary between 2003 and 2011. Serum parameters were measured by RIA/IRMA assays; tumor tissue ER, PR and HER2 status was assessed histologically. Patients were classified according to tumor receptor status. Case-case analysis subjects were categorized into four subgroups based on serum hormone concentrations in ER, PR and HER2 receptor-negative cases, respectively.
  
  
  RESULTS
  Serum estrone sulfate and dehydroepiandrosterone sulfate levels correlated with each other and also with serum estrone and estradiol levels. According to case-case study the odds ratios in the highest quartile were 1.517 (p = 0.0305, Ptrend = 0.0394) for androstenedione, 1.495 (p = 0.0317, Ptrend < 0.0105) for estrone and 0.654 (p = 0.0273, Ptrend < 0.0151) for estrone sulfate/estrone ratio in PR+ vs. PR- tumors. Regarding HER2 status (HER2+ vs. HER2-), the odds ratios for estrone, estrone sulfate and estrone sulfate/estrone ratio were 0.530 (p = 0.0234, Ptrend = 0.0595), 2.438 (p = 0.0042, Ptrend < 0.0066) and 3.118 (p = 0.0001, Ptrend < 0.0001) in the highest quartile, respectively. Of note significantly increased BMI associates with PR+ and ER +/PR+ status while significantly decreased BMI was observed in HER2+ cases.
  
  
  CONCLUSIONS
  Taken together, measurement of serum estrone and estrone sulfate concentrations prior to surgical intervention might support the individualization of regime in postmenopausal primary breast cancer patients.
authors.affiliation: Department of Biochemistry, National Institute of Oncology, 1122 Budapest, Ráth György u. 7-9., Hungary.
authors.forename: Borbála
authors.initials: B
authors.lastname: Vincze
authors.affiliation: Department of Biochemistry, National Institute of Oncology, 1122 Budapest, Ráth György u. 7-9., Hungary.
authors.forename: Bence
authors.initials: B
authors.lastname: Kapuvári
authors.affiliation: Surgical and Molecular Tumor Pathology Centre, National Institute of Oncology, Budapest, Hungary.
authors.forename: Nóra
authors.initials: N
authors.lastname: Udvarhelyi
authors.affiliation: Clinic of Oncology, Centre of Clinics, University of Debrecen, 4032 Debrecen, Nagyerdei krt. 98., Hungary.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Horváth
authors.affiliation: Department of General and Thoracic Surgery, National Institute of Oncology, Budapest, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Mátrai
authors.affiliation: Department of General and Thoracic Surgery, National Institute of Oncology, Budapest, Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Czeyda-Pommersheim
authors.affiliation: Department of Biochemistry, National Institute of Oncology, 1122 Budapest, Ráth György u. 7-9., Hungary.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Kőhalmy
authors.affiliation: Department of Biochemistry, National Institute of Oncology, 1122 Budapest, Ráth György u. 7-9., Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Kovács
authors.affiliation: Department of Biochemistry, National Institute of Oncology, 1122 Budapest, Ráth György u. 7-9., Hungary.
authors.forename: Mariann
authors.initials: M
authors.lastname: Boldizsár
authors.affiliation: Medical Oncology and Clinical Pharmacology "B", National Institute of Oncology, Budapest, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Láng
authors.affiliation: National Institute of Oncology, Budapest, Hungary.
authors.forename: Miklós
authors.initials: M
authors.lastname: Kásler
keywords: Estrone; Estrone sulfate; HER2; Invasive ductal carcinoma; Postmenopausal breast cancer; Progesterone receptor