title: Systemic Levels of Estrogens and PGE2Synthesis in Relation to Postmenopausal Breast Cancer Risk.
abstract: Background:Prostaglandin E2(PGE2) induces aromatase expression in adipose tissue, leading to increased estrogen production that may promote the development and progression of breast cancer. However, few studies have simultaneously investigated systemic levels of PGE2and estrogen in relation to postmenopausal breast cancer risk.Methods:Here, we determined urinary estrogen metabolites (EM) using mass spectrometry in a case-cohort study (295 incident breast cancer cases and 294 subcohort members), and using linear regression estimated the effect of urinary levels of a major PGE2metabolite (PGE-M) on EMs. HRs for the risk of developing breast cancer in relation to PGE-M and EMs were compared between Cox regression models with and without mutual adjustment.Results:PGE-M was a significant predictor of estrone (E1), but not estradiol (E2) levels in multivariable analysis. Elevated E2 levels were associated with an increased risk of developing breast cancer [HRQ5vs.Q1, 1.54; 95% confidence interval (CI), 1.01-2.35], and this association remained unchanged after adjustment for PGE-M (HRQ5vs.Q1, 1.52; 95% CI, 0.99-2.33). Similarly, elevated levels of PGE-M were associated with increased risk of developing breast cancer (HRQ4vs.Q1, 2.01; 95% CI, 1.01-4.29), and this association was only nominally changed after consideration of E1 or E2 levels.Conclusions:Urinary levels of PGE-M and estrogens were independently associated with future risk of developing breast cancer among these postmenopausal women.Impact:Increased breast cancer risk associated with PGE-M might not be fully explained by the estrogens-breast cancer association alone but also by additional effects related to inflammation.Cancer Epidemiol Biomarkers Prev; 26(3); 383-8. ©2016 AACR.
authors.affiliation: Medical College of Georgia, Department of Medicine, Section of Hematology/Oncology, Augusta University Georgia Cancer Center, Augusta, Georgia. sankim@augusta.edu.
authors.forename: Sangmi
authors.initials: S
authors.lastname: Kim
authors.affiliation: Medical College of Georgia, Department of Medicine, Section of Hematology/Oncology, Augusta University Georgia Cancer Center, Augusta, Georgia.
authors.forename: Jeff
authors.initials: J
authors.lastname: Campbell
authors.affiliation: Institute of Public and Preventive Health - Data Coordinating Center, Augusta University, Augusta, Georgia.
authors.forename: Wonsuk
authors.initials: W
authors.lastname: Yoo
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.
authors.forename: Jack A
authors.initials: JA
authors.lastname: Taylor
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina.
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015415:Biomarkers / Q000652:urine; D001943:Breast Neoplasms / Q000652:urine*; D016022:Case-Control Studies; D015331:Cohort Studies; D015232:Dinoprostone / Q000652:urine*; D004958:Estradiol / Q000652:urine; D004967:Estrogens / Q000652:urine*; D004970:Estrone / Q000652:urine; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D017698:Postmenopause / Q000652:urine*; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D004967:Estrogens; D004970:Estrone; D004958:Estradiol; D015232:Dinoprostone