Sex hormone levels and risks of estrogen receptor-negative and estrogen receptor-positive breast cancers

Farhat, GN and Cummings, SR and Chlebowski, RT and Parimi, N and Cauley, JA and Rohan, TE and Huang, AJ and Vitolins, M and Hubbell, FA and Manson, JE and Cochrane, BB and Lane, DS and Lee, JS (2011) Sex hormone levels and risks of estrogen receptor-negative and estrogen receptor-positive breast cancers. Journal of the National Cancer Institute, 103 (7). 562 - 570. ISSN 0027-8874

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Abstract

BackgroundEndogenous sex hormone levels are associated with risks of breast cancer overall and estrogen receptor (ER)-positive breast tumors; however, their associations with ER-negative tumors remain unclear.MethodsIn a case-cohort study within the Women's Health Initiative Observational Study among postmenopausal women aged 50-79 years, we examined associations between endogenous testosterone and estradiol levels and the risks of ER-negative and ER-positive breast cancers. Serum levels of bioavailable testosterone and estradiol were assessed at the baseline visit in 317 invasive breast cancer case subjects and in a subcohort of 594 women. Bioavailable sex hormone levels were calculated using the total hormone level and the sex hormone-binding globulin concentration (measured by radioimmunoassays and a chemiluminescent immunoassay, respectively). Cox proportional hazards regression was used for statistical analysis. All statistical tests were two-sided.ResultThe unadjusted absolute rates of ER-negative breast cancer for testosterone quartiles 1-4 were 0.34, 0.20, 0.23, and 0.21 per 10000 person-years, respectively. Compared with women in the lowest quartile of testosterone level, those in quartile 2 had a 56% lower risk of ER-negative cancer (hazard ratio [HR] = 0.44, 95% confidence interval [CI] = 0.23 to 0.85), those in quartile 3 had a 45% lower risk (HR = 0.55, 95% CI = 0.30 to 1.01), and those in quartile 4 had a 49% lower risk (HR = 0.51, 95% CI = 0.28 to 0.94), independent of other risk factors. Estradiol level was not associated with ER-negative breast cancer. ER-positive breast cancer risk increased with higher testosterone levels (Ptrend =. 04), but this trend was not statistically significant after adjustment for estradiol (Ptrend =. 15). ER-positive cancer risk was approximately twofold higher in women with estradiol levels in quartiles 2-4 compared with women in quartile 1, independent of risk factors.ConclusionHigher serum levels of bioavailable testosterone are associated with lower risks of ER-negative breast cancer in postmenopausal women. © 2011 The Author.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Farhat, GN Cummings, SR Chlebowski, RT Parimi, N Cauley, JA JCauley@edc.pitt.edu JCAULEY Rohan, TE Huang, AJ Vitolins, M Hubbell, FA Manson, JE Cochrane, BB Lane, DS Lee, JS
Date:	6 April 2011
Date Type:	Publication
Journal or Publication Title:	Journal of the National Cancer Institute
Volume:	103
Number:	7
Page Range:	562 - 570
DOI or Unique Handle:	10.1093/jnci/djr031
Schools and Programs:	Graduate School of Public Health > Epidemiology
Refereed:	Yes
ISSN:	0027-8874
Date Deposited:	03 Apr 2015 16:40
Last Modified:	02 Feb 2019 21:55
URI:	http://d-scholarship.pitt.edu/id/eprint/24217

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