Ductal Carcinoma in Situ: Link Between Estradiol/Testosterone Levels and Increased Risk?
Posted: Monday, June 15, 2020
According to a prospective study, elevated total and free estradiol levels appeared to increase the risk of ductal carcinoma in situ among premenopausal women. In addition, among postmenopausal women, elevated levels of total and free testosterone increased the risk of ductal carcinoma in situ, whereas elevated sex hormone–binding globulin (SHBG) levels were inversely associated with risk of ductal carcinoma in situ.
“These findings may provide valuable information for developing risk prediction models as well as prevention strategies aimed at reducing risk of breast cancer among premenopausal and postmenopausal women,” concluded Rhonda S. Arthur, PhD, of Albert Einstein College of Medicine, New York, and colleagues, who published their findings in Cancer Epidemiology, Biomarkers & Prevention.
The UK Biobank data focused on women between the ages of 40 and 69 from 2006 to 2010 from across 22 centers in the United Kingdom. A total of 182,935 women who qualified for the study had serum levels of estradiol, testosterone, and SHBG drawn; they were also categorized as premenopausal or postmenopausal.
With a median follow-up of 7.1 years, 717 ductal carcinomas in situ cases were confirmed: 186 cases in premenopausal women and 531 cases in postmenopausal women. In addition to previously stated hormone level associations, women with ductal carcinoma in situ were found to have a higher proportion of family history of breast cancer in a first-degree relative and previous mammographic screening. Compared with postmenopausal women without ductal carcinoma in situ, those with ductal carcinoma in situ were less likely to be nulliparous.
Estradiol levels were assessed only in premenopausal women, since low levels were not accurately detected in postmenopausal women. Further study limitations included a one-time measure of hormone levels in assessing the risk of ductal carcinoma in situ. Future studies should include non-European women, as this study focused mainly on European women, and should explore the risk associations for various hormone receptor subtypes of ductal carcinoma in situ.
Disclosure: For full disclosures of the study authors, visit cebp.aacrjournals.org.