Abstract
Inadequate corpus luteum function is discussed in a pathophysiological interpretation of human breast cancer epidemiology. Detailed hormonal studies of normal and abnormal human reproductive cycles have given evidence that inadequate corpus luteum secretory function is 1 of the characteristic features of infertile and/or irregular menstrual cycles. Age at menarche and menopause parity and androgen and estrogen secretion have all been related to breast cancer development. Treated independently these risk factors have been of little assistance in the identification of individuals with a predisposition to breast cancer development. The hypothesis that breast cancer risk factors are the manifestation of inadequate corpus luteum function can be tested epidemiologically. If correct an attempt can be made early in reproductive life to identify and treat those who manifest luteal phase inadequacy. The hypothesis was strongly suggested that estrogenic stimulation in the absence of sufficient cyclic progesterone secretion may provide a setting favorable to the development of mammary carcinoma. It is apparent that limited luteal phase progesterone secretion occurs in the presence or absence of gross irregularity of the menstrual cycle. The importance of these findings was strengthened by a study of premenstrual endometrial biopsies from 87 women with breast cancer and 50 normal women. Normal secretory endometrium was found in 68% of controls and only 17% of breast cancer patients.
Published Version
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