Some aspects of oestrogen metabolism in cases of human mammary neoplasias

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1. 1. The urinary excretion patterns of oestradiol- 17β, oestrone and oestriol were estimated on forty-seven women with breast cancer and co-existing mastopathy (“group A”, average age 52 years) and on fifty-six women with breast cancer and no mastopathy (“group B”, average age 56 years). All mammary lesions of the cases studied were verified by histological examination of the primary tumour and the surrounding tissues. For oestrogen assays, the chemical method described by Brown, Bulbrook and Greenwood was employed. The mean amounts of the total oestrogen excreted per 24 hr were 18·4 μg in group A and 13·2 μg in group B. The difference of these figures is a significant one ( p < 0·01; x 2 -test) and not due to the age difference of the groups. The average proportion of (oestradiol + oestrone) was computed on 60 per cent of the total oestrogen output in group A and on only 40 per cent in group B. 2. 2. Twelve women of group A and twenty-six women of group B were submitted to an oestrogen loading test (daily injections of 5 mg oestradiol benzoate i.m. on 3 consecutive days). The increase of the total oestrogen excretion during the test was nearly identical in both groups studied ( 202 μg/ 24 hr in group A and 211 μg/ 24 hr in group B). Oestradiol loading caused a marked augmentation of the (oestradiol + oestrone) proportion by 20·2 per cent in group A, whereas in group B the corresponding figure increased by 8·6 per cent only. 3. 3. To each of fourteen women of group A and twenty-three women of group B daily injections of 100 mg of testosterone propionate were given i.m. on three consecutive days. During this hormone loading, the total additional oestrogen excretion amounted on the average to 16·2 μg/ 24 hr in group A and 16·3 μg/ 24 hr in group B. There was a mean increase of the rate of (oestradiol + oestrone) by 12·6 per cent in group A and by 1·9 per cent in group B. 4. 4. From the present study it is likely that a good deal of breast cancer patients with co-existing mastopathy have a lesser metabolic capacity of converting endogenous or exogenous oestradiol and oestrone to oestriol in comparison with women suffering from “simple” breast cancer.