Influence of tumour oestrogen concentration on prognosis in breast cancer: studies in pre- and post-menopausal patients of different ethnic groups

Summary Epidemiologic and clinical evidence suggest that oestrogens play a role in sustaining and promoting breast cancer. The relationship of tumour oestrogen levels and other features of breast cancer is, however, poorly understood. The present study included 108 patients with primary breast cancer who had tumour oestrone (E1) and oestradiol (E2) as well as oestrogen and progesterone receptors and aromatization capacity measured. The patient population included both pre- and post-menopausal women and comprised both black and Caucasian subjects. Tumour oestrogen concentrations were significantly lower in premenopausal as compared to post-menopausal patients while E2 measurements were higher in premenopausal as compared to post-menopausal patients. There was no significant correlation between either tumour oestrogen level and hormone receptor status. Tumour oestrogen and progesterone receptor concentrations as well as tumour E1 concentrations were lower in black post-menopausal patients as compared to those found in white post-menopausal patients. In a multivariate analysis both disease free and overall survival were significantly lower in patients with higher tumour E1 levels. Other factors of prognostic significance were race, tumour size (T) and nodal status (N). These findings suggest that tumour hormone content may influence the behaviour of breast cancer independantly of hormone receptor status.