Estradiol and testosterone associated with risk of breast cancer: a meta-analysis

Meta-analysis: Hormones' Role in Breast Cancer Risk

  • Yanqing Liu Breast Surgery Department, Yantai Yuhuangding Hospital
  • Yujuan Kang
  • Xiaofei Li
  • Nina Qu
Keywords: estradiol, Testosterone, Breast cancer, meta-analysis

Abstract


Background: To investigate the correlation between estradiol and testosterone in patients with breast cancer.

Methods: The literatures on the correlation between estradiol and testosterone on the risk of breast cancer were searched and collected. The time limit is that each database is established until December 2023. After screening, the modified Jadad scale was used to evaluate the quality of the research literature. NoteExpress 3.2 was used for literature management, and Excel 2003 was used for data collection and extraction. Statistical analysis was performed using RevMan 5.4.1 software to determine whether there was heterogeneity in the study according to the size of Q test (P-value), and then the OR value of combined effects was calculated using fixed or random effects models and forest maps were drawn. At the same time, the literatures with the greatest weight were excluded for sensitivity analysis, and the literature bias was evaluated by drawing funnel plot.

Results: A total of 628 literatures were retrieved, and 11 case-control trials met the criteria for inclusion. Meta-analysis results showed that the level of E2 in breast cancer patients was higher than that in non-breast cancer control group, but the difference was not statistically significant (OR=121.56, 95%CI (-3.32-264.44), P=0.06). The level of E2 in premenopausal patients with breast cancer was higher than that in non-breast cancer control group, but the difference was not statistically significant (OR=8.26, 95%CI (-2.83-19.34), P=0.14). The level of E2 in postmenopausal patients with breast cancer was higher than that in non-breast cancer control group, and the difference was statistically significant (OR=20.36, 95%CI (7.04-33.68), P=0.003). Preoperative T level was higher in patients with breast cancer than in non-breast cancer control group, but the difference was not statistically significant (OR=14.77, 95%CI (-14.11-43.65), P=0.32). The T level before and after surgery in breast cancer patients was higher than that in non-breast cancer control group, and the difference was statistically significant (OR=12.91, 95%CI (4.43-21.39), P=0.003). Sensitivity analysis showed that the combined effect size results were stable and reliable OR (95%CI) was 24.41 (10.21~38.61), P=0.0007. Funnel plot results showed publication bias.

Conclusion There is a positive correlation between the levels of estradiol and testosterone and the occurrence and development of breast cancer after menopause.

References

1. Burstein HJ, Curigliano G, Thürlimann B, Weber WP, Poortmans P, Regan MM, et al. Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer 2021. Ann Oncol 2021; 32(10):1216-35.
2. Zhang Q, Liu LY, Wang F, Mu K, Yu ZG. The changes in female physical and childbearing characteristics in China and potential association with risk of breast cancer. Bmc Public Health 2012; 12: 368.
3. Rogers AE. Diet and breast cancer: studies in laboratory animals. J Nutr 1997; 127(5 Suppl): 933S-935S.
4. D'Avanzo B, Negri E, Gramenzi A, Franceschi S, Parazzini F, Boyle P, et al. Fats in seasoning and breast cancer risk: an Italian case-control study. Eur J Cancer 1991; 27(4): 420-3.
5. Potischman N, Weiss HA, Swanson CA, Coates RJ, Gammon MD, Malone KE, et al. Diet during adolescence and risk of breast cancer among young women. Jnci-J Natl Cancer I 1998; 90(3): 226-33.
6. Willett WC. Diet and breast cancer. J Intern Med 2001; 249(5): 395-411.
7. Varghese JS, Smith PL, Folkerd E, Brown J, Leyland J, Audley T, et al. The heritability of mammographic breast density and circulating sex-hormone levels: two independent breast cancer risk factors. Cancer Epidem Biomar 2012; 21(12): 2167-75.
8. Sprague BL, Trentham-Dietz A, Gangnon RE, Buist DS, Burnside ES, Bowles EJ, et al. Circulating sex hormones and mammographic breast density among postmenopausal women. Horm Cancer-Us 2011; 2(1): 62-72.
9. Li J, Humphreys K, Eriksson L, Edgren G, Czene K, Hall P. Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer. J Clin Oncol 2013; 31(18): 2249-56.
10. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. Jama-J Am Med Assoc 2002; 288(3): 321-33.
11. Eliassen AH, Missmer SA, Tworoger SS, Spiegelman D, Barbieri RL, Dowsett M, et al. Endogenous steroid hormone concentrations and risk of breast cancer among premenopausal women. Jnci-J Natl Cancer I 2006; 98(19): 1406-15.
12. Kaaks R, Berrino F, Key T, Rinaldi S, Dossus L, Biessy C, et al. Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). Jnci-J Natl Cancer I 2005; 97(10): 755-65.
13. Micheli A, Muti P, Secreto G, Krogh V, Meneghini E, Venturelli E, et al. Endogenous sex hormones and subsequent breast cancer in premenopausal women. Int J Cancer 2004; 112(2): 312-8.
14. Li DD, Liu J. Relationship of endogenous estrogens level and breast tumor in postmenopausal women. Jiangsu Med J 2012; 38(12): 1415-6.
15. Li DD. Relations of levels of endogenous sex hormones and blood lipids with breast cancer in postmenopausal women. Chin J Gen Surg 2015; 24(5): 687-91.
16. Chen XR, Xiao BR, Cheng H. Clinical analysis of B - ultrasound combined with thyroid hormone and estradiol levels in patients with breast cancer. Chin J Health Lab Tec 2019; 29(10): 1230-2.
17. Shi Y, Feng M, Huang YC. Correlation between Th1/Th2 and estrogen levels in peripheral blood of patients with breast cancer. J Pract Med 2012; 28(2): 280-2.
18. Miu SY. Sex hormone metabolomics and the mechanism of cell malignant transformation induced by 4-Hydroxyestradiol in patients with breast cancer. Doctor; Nanjing Med Univ 2015; Nanjing City, Jiangsu province, China.
19. Huang RF. The relationship between the incidence of breast cancer in postmenopausal women and the relationship between serum sex hormone level and body mass index. J Pract Gynecol Endocrinol 2018; 5(8): 1-3.
20. Ma RL, Zhang HC, Li GQ, Xu XY, Zhou LY. Plasma sex hormone levels and breast cancer in premenopausal women Dangerous relationship. Cancer Prev Treat Res 2013; 40(7): 667-70.
21. Xu H, Wang WZ, Zhang XG, Chen XG, Yang KP. Study on the relationship between serum estradiol, progesterone and breast diseases. J Med Grad Stud 2004; 17(1): 30-32.
22. Ma RL. Relationship between serum hormone levels and risk and prognostic factors of female breast cancer. Master; Shandong Univ 2007; Jinan City, Shandong province, China.
23. Lin DL, Chen JQ, Feng HY, Cai MT, Wang YX. Correlation analysis of serum sex hormone levels, body mass index and breast cancer progression in postmenopausal women. Jilin Med Coll 2020; 41(1): 38-40.
24. Kang XM, Wang L, Fu XN, Wang H, Zhang QY. Relationship between serum sex hormone and breast density and breast cancer in postmenopausal women. J Harbin Med Univ 2014; (5): 386-9.
25. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008; 371(9612): 569-78.
26. Berclaz G, Li S, Price KN, Coates AS, Castiglione-Gertsch M, Rudenstam CM, et al. Body mass index as a prognostic feature in operable breast cancer: the International Breast Cancer Study Group experience. Ann Oncol 2004; 15(6): 875-84.
27. Jokar N, Velikyan I, Ahmadzadehfar H, Rekabpour SJ, Jafari E, Ting HH, et al. Theranostic Approach in Breast Cancer: A Treasured Tailor for Future Oncology. Clin Nucl Med 2021; 46(8): e410-20.
Published
2024/08/06
Section
Original paper