Abstract

IntroductionMammographically dense breast tissue is a strong predictor of breast cancer risk, and is influenced by both mitogens and mutagens. One enzyme that is able to affect both the mitogenic and mutagenic characteristics of estrogens is cytochrome P450 1A2 (CYP1A2), which is principally responsible for the metabolism of 17β-estradiol.MethodsIn a cross-sectional study of 146 premenopausal and 149 postmenopausal women, we examined the relationships between CYP1A2 activity, malondialdehyde (MDA) levels, and mammographic density. In vivo CYP1A2 activity was assessed by measuring caffeine metabolites in urine. Levels of serum and urinary MDA, and MDA–deoxyguanosine adducts in DNA were measured. Mammograms were digitized and measured using a computer-assisted method.ResultsCYP1A2 activity in postmenopausal women, but not in premenopausal women, was positively associated with mammographic density, suggesting that increased CYP1A2 activity after the menopause is a risk factor for breast cancer. In premenopausal women, but not in postmenopausal women, CYP1A2 activity was positively associated with serum and urinary MDA levels; there was also some evidence that CYP1A2 activity was more positively associated with percentage breast density when MDA levels were high, and more negatively associated with percentage breast density when MDA levels were low.ConclusionThese findings provide further evidence that variation in the activity level of enzymes involved in estrogen metabolism is related to levels of mammographic density and potentially to breast cancer risk.

Highlights

  • Dense breast tissue is a strong predictor of breast cancer risk, and is influenced by both mitogens and mutagens

  • Adjustments were made for smoking status because tobacco smoke is inversely associated with mammographic density [37] and is a known inducer of cytochrome P450 1A2 (CYP1A2) activity [38]

  • CYP1A2 activity was positively associated with serum (P = 0.03) and urinary (P = 0.04) MDA levels in premenopausal but not in postmenopausal women (P ≥ 0.58)

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Summary

Introduction

Dense breast tissue is a strong predictor of breast cancer risk, and is influenced by both mitogens and mutagens. Increased amounts of stromal and epithelial tissue in the breast is a strong independent risk factor for breast cancer, and they appear as light areas on a mammogram because they are radiologically dense. These areas are referred to as 'mammographic density'. Mammographic density levels decline with increasing age, onset of menopause, increasing body weight and parity, and younger age at first childbirth [1]. Density levels increase with hormone replacement therapy [2], and are reduced with tamoxifen [3] and a gonadotrophin release agonist [4]

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