Abstract
BackgroundWe investigated in postmenopausal women with primary breast cancer prior to surgical intervention whether, serum levels of different steroid hormones and hormonal precursors associated with tumor tissue estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status.MethodsWe enrolled 1,042 patients suffering invasive ductal carcinoma undergoing surgical resection in the National Institute of Oncology, Hungary between 2003 and 2011. Serum parameters were measured by RIA/IRMA assays; tumor tissue ER, PR and HER2 status was assessed histologically. Patients were classified according to tumor receptor status. Case–case analysis subjects were categorized into four subgroups based on serum hormone concentrations in ER, PR and HER2 receptor-negative cases, respectively.ResultsSerum estrone sulfate and dehydroepiandrosterone sulfate levels correlated with each other and also with serum estrone and estradiol levels. According to case–case study the odds ratios in the highest quartile were 1.517 (p = 0.0305, Ptrend = 0.0394) for androstenedione, 1.495 (p = 0.0317, Ptrend < 0.0105) for estrone and 0.654 (p = 0.0273, Ptrend < 0.0151) for estrone sulfate/estrone ratio in PR+ vs. PR− tumors. Regarding HER2 status (HER2+ vs. HER2−), the odds ratios for estrone, estrone sulfate and estrone sulfate/estrone ratio were 0.530 (p = 0.0234, Ptrend = 0.0595), 2.438 (p = 0.0042, Ptrend < 0.0066) and 3.118 (p = 0.0001, Ptrend < 0.0001) in the highest quartile, respectively. Of note significantly increased BMI associates with PR+ and ER +/PR+ status while significantly decreased BMI was observed in HER2+ cases.ConclusionsTaken together, measurement of serum estrone and estrone sulfate concentrations prior to surgical intervention might support the individualization of regime in postmenopausal primary breast cancer patients.
Highlights
We investigated in postmenopausal women with primary breast cancer prior to surgical intervention whether, serum levels of different steroid hormones and hormonal precursors associated with tumor tissue estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status
HER2 expression is presented in 20–25% of breast cancer cases that are classified as HER2-positive (HER2+) (Ross et al 2009; Dawood et al 2010)
Our aim was to investigate whether circulating steroid hormone levels including sexual hormones and their precursors along with sex hormone binding globulin [i.e. E1, estrone sulfate (E1S), E2, TE, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), androstenedione (AD) and SHBG] measured prior surgical intervention show any association with tumor ER, PR and HER2 status in postmenopausal women with primary breast cancer
Summary
We investigated in postmenopausal women with primary breast cancer prior to surgical intervention whether, serum levels of different steroid hormones and hormonal precursors associated with tumor tissue estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status. Most important biological features determining therapy are endocrine sensitivity, human epidermal growth factor receptor 2 (HER2) expression and proliferative capability of the tumor (Láng et al 2012). 70% of breast cancer cases express estrogen receptor (ER) and progesterone receptor (PR) are referred as hormone receptor (HR)-positive. HER2 expression is presented in 20–25% of breast cancer cases that are classified as HER2-positive (HER2+) (Ross et al 2009; Dawood et al 2010). About 10–20% of invasive breast cancer cases do not express ER, PR or HER2 and are termed as of triple negative receptor status (ER−/PR−/ HER2−) (Perou 2011; Aysola et al 2013)
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