Estrogen metabolism and mammographic density in postmenopausal women: a cross-sectional study.
Abstract
BACKGROUND
Prospective studies have consistently found that postmenopausal breast cancer risk increases with circulating estrogens; however,
findings from studies of estrogens and mammographic density (MD), an intermediate marker of breast cancer risk, have been
inconsistent. We investigated the cross-sectional associations of urinary estrogens, and their 2-, 4-, and 16-hydroxylated
metabolites with MD.
METHODS
Postmenopausal women without breast cancer (n = 194), ages 48 to 82 years, and reporting no current menopausal hormone therapy
use were enrolled at a clinic in Western NY in 2005. Urinary estrogens and estrogen metabolites were measured using mass spectrometry.
Percent MD and dense area (cm(2)) were measured using computer-assisted analyses of digitized films. Linear regression models
were used to estimate associations of log-transformed estrogen measures with MD while adjusting for age, body mass index (BMI),
parity, and past hormone therapy use.
RESULTS
Urinary concentrations of most individual estrogens and metabolites were not associated with MD; however, across the interdecile
range of the ratio of parent estrogens (estrone and estradiol) to their metabolites, MD increased by 6.8 percentage points
(P = 0.02) and dense area increased by 10.3 cm(2) (P = 0.03). Across the interdecile ranges of the ratios of 2-, 4-, and 16-hydroxylation
pathways to the parent estrogens, MD declined by 6.2 (P = 0.03), 6.4 (P = 0.04), and 5.7 (P = 0.05) percentage points, respectively.
All associations remained apparent in models without adjustment for BMI.
CONCLUSION
In this study of postmenopausal women, less extensive hydroxylation of parent estrogens was associated with higher MD.
IMPACT
Hydroxylation of estrogens may modulate postmenopausal breast cancer risk through a pathway involving MD.
Links
Authors
Fuhrman BJ, Brinton LA, Pfeiffer RM, Xu X, Veenstra TD, Teter BE, Byrne C, Dallal CM, Barba M, Muti PC, Gierach GL
Institution
Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892, USA. fuhrmanb@mail.nih.gov
Source
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 21:9 2012 Sep pg 1582-91MeSH
AgedAged, 80 and over
Body Mass Index
Cross-Sectional Studies
Estrogens
Female
Humans
Hydroxylation
Linear Models
Mammography
Middle Aged
Postmenopause
Pub Type(s)
Journal ArticleResearch Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Language
eng
PubMed ID
22736791
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