The relationship between family history, exposure to exogenous hormones, and estrogen receptor protein in breast cancer

Autor: Morton K. Schwartz, Edward J. Beattie, David W. Kinne, Michael P. Osborne, Martin Lesser, Paul Peter Rosen, Jack H. Fishman, Celia J. Menendez-Botet
Rok vydání: 1983
Předmět:
Zdroj: Cancer. 51:2134-2138
ISSN: 1097-0142
0008-543X
Popis: 813 patients were prospectively studied to examine the influence of family history and the prior use of exogenous hormones as covariables in the subsequent expression of estrogen receptor protein (ERP) in the primary tumor of patients with breast cancer. Cases were divided by menstrual status: there were 385 pre- and perimenopausal and 428 postmenopausal patients. The influence of prior exposure to estrogen replacement therapy (ERT) in postmenopausal patients or oral contraceptives (OCs) in pre- and perimenopausal patients on tumor ERP was analyzed by controlling for family history: none 1st degree (mother or sister) 2nd degree (grandmother or aunt) or both 1st and 2nd degree relatives. The results showed no influence of the prior use of ERT in postmenopausal women on subsequent tumor ERP. Among pre- and perimenopausal women those with a family history of breast cancer in only a 1st degree relative showed a borderline significant association between prior OC usage and subsequent tumor ERP. The use of OCs was consistently associated with ERP negative tumors (9/9) whereas of 29 patients who had prior OC exposure 17 had ERP negative tumors (P=0.04 Fishers Exact Test). Analysis of the prior exposure to OCs verified with the primary physician care or pharmacist showed that these patients first used OCs at the mean age of 32.2 years had used OCs for a mean duration of 41.9 months and stopped OC use a mean of 79.5 months before being diagnosed as having breast cancer. These results suggest that in a subset of patients with breast cancer and a 1st degree relative who only had breast cancer prior exposure to OCs may influence the subsequent ERP status of the tumor. This is not due to exogenous estrogen saturation of receptors as there was a long latent period between exposure and diagnosis. Alternative hypotheses as to the mechanism of selection of subsequent tumor ERP may be either inhibition of ERP positive preneoplastic or tumor cell clones early in the evolution of the tumor or early selection of a tumor capable of endogenous estrogen synthesis with receptor saturation. (authors modified)
Databáze: OpenAIRE
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