Plasma testosterone and prognosis of postmenopausal breast cancer patients.

Full Abstract

PURPOSE: High endogenous testosterone is associated with increased breast cancer (BC) risk. We designed this study specifically to assess the long-term prognostic role of testosterone in a cohort of postmenopausal BC patients. PATIENTS AND METHODS: We considered 194 postmenopausal women, operated on for early BC (T1-2N0M0), who never received chemotherapy or hormonal therapy, and who participated in a fenretinide BC prevention trial as untreated controls. Blood samples were collected 3 months (median) after surgery; plasma samples, stored at -80 degrees C, were radioimmunoassayed for testosterone. Median follow-up was 14 years. The main end point was any cancer event. Event-free survival was estimated by the Kaplan-Meier method. Hazard ratios (HRs) of events by testosterone level were estimated by the Cox model, adjusting for age, tumor size, and histology. RESULTS: Patients with high testosterone (> or = 0.40 ng/mL, median of distribution) had significantly lower event-free survival than those with low testosterone (log-rank P = .004). The adjusted HR of patients with high versus low testosterone was 2.05 (95% CI, 1.28 to 3.27). High testosterone was also associated with a significantly higher risk of BC events (relapse and second primary) with an adjusted HR of 1.77 (95% CI, 1.06 to 2.96). Eleven second primaries (non-BC) occurred in the high-testosterone group, four in the low-testosterone group. CONCLUSION: High plasma testosterone strongly predicts poorer prognosis in postmenopausal BC patients not administered adjuvant therapy. Testosterone levels should be determined as part of the prognostic work-up.

Author information

Author/s: Micheli, Andrea (A); Meneghini, Elisabetta (E); Secreto, Giorgio (G); Berrino, Franco (F); Venturelli, Elisabetta (E); Cavalleri, Adalberto (A); Camerini, Tiziana (T); Di Mauro, Maria G (MG); Cavadini, Elena (E); De Palo, Giuseppe (G); Veronesi, Umberto (U); Formelli, Franca (F);

Affiliation: Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. andrea.micheli(-atsign-)istitutotumori.mi.it

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol), published in United States. (Language: eng)

Reference: 2007-Jul; vol 25 (issue 19) : pp 2685-90

Dates: Created 2007/07/02; Completed 2007/07/19;

PMID: 17548841, status: MEDLINE (last retrieved date: 2/18/2009)

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