Circulating hormone levels in breast cancer patients.: Correlation with serum tumor markers and the clinical and biological features of the tumors

Background: Breast cancer grows in a hormone-rich environment which influences its biological features and thus, ultimately, its clinical behavior. Circulating hormone levels were measured in premenopausal and postmenopausal breast cancer patients prior to surgery, and correlated with all available clinical and biological features of the tumors and with serum tumor marker levels. Materials and Methods: FSH, LH, 17-beta-estradiol, progesterone and prolactin were measured in 112 previously untreated breast cancer patients (54 premenopausal and 58 postmenopausal). Serum tumor markers (CEA, CA 15.3, CA-125 and Ca19.9) were measured at the same time. All tumors were studied after surgery for hormone receptor (ER and PR), Ki67, c-erb-B2 and p53 expression by means of immunohistochemistry, and for DNA-ploidy by means of flow cytometry. Results: In premenopausal patients, high gonadotropin levels correlated directly with c-erb-B2 overexpression by the tumors (FSH: p=0.02; LH: p=0.05). High estradiol levels correlated inversely (p=0.009) with Ki67 expression. In postmenopausal patients, high estradiol levels were inversely related to c-erb-B2 expression by the tumors (p=0.03), and high progesterone levels were also inversely related to Ki67 expression by the tumors (p=0.05). FSH levels correlated inversely (p=0.02) with circulating carcinoembryonic antigen (CEA) levels. Conclusion: Circulating estradiol levels seem to be associated with a less proliferative breast cancer phenotype. FSH and LH levels, on the other hand, seem to exert dual actions in premenopausal and postmenopausal breast cancer patients.