Relation Between Urinary Androgen and Corticoid Excretion and Subsequent Breast Cancer

Breast cancer: A comparison of response to endocrine therapy and oestrogen excretion patterns including unusual metabolites

“…Previous work on urinary-oestrogen excretion profiles in breast cancer has failed to identify a reliable discriminant between those who will respond to endocrine therapy and those who will not (Bulbrook et al, 1971). E3R has been shown to discriminate well between breastcancer patients and controls (Lemon et al, 1966) and between different populations of women with different incidences of breast cancer (MacMahon et al, 1971).…”

“…Before the advent of receptor analyses, several steroid metabolic discriminants were used, with varying degrees of success (Bulbrook et al, 1960;1971;Lemon et al, 1966;MacMahon et al, 1971), to identify potential responders to hormone therapy. Renewed interest in the metabolism of oestrogen in breast-cancer patients has arisen because certain of the hydroxymetabolites can bind oestrogen receptor without promoting target-cell growth (Martucci & Fishman, 1976) and so might act as protective agents against neoplastic induction by biologically active oestrogens.…”

Urinary androgens and breast cancer risk: results from a long-term prospective study based in Guernsey

“…The initial results of the study (Bulbrook and Hayward, 1967;Bulbrook et al, 1971) came mainly from premenopausal women in whom a low discriminant function (i.e. low androgen relative to hydroxycorticoid excretion) was associated with increased breast cancer risk.…”

“…The position of oestrogens and premenopausal women is uncertain (Key and Pike, 1988; Thomas et al, 1997). Androgens have been studied less extensively than oestrogens and no meta-analysis has yet been undertaken.The first prospective study in this field was performed by Bulbrook and Hayward who showed that levels of androsterone (A) and aetiocholanolone (E) were abnormally low in women who subsequently developed breast cancer (Bulbrook and Hayward, 1967;Bulbrook et al, 1971). Most of the cases were premenopausal and the abnormality was present up to 11 years before the clinical diagnosis of the disease, suggesting that high levels of androgen metabolites might have a protective effect, at least in younger women.…”

Concentration of testosterone glucuronide in urine from women with breast tumours

“…Accordingly, our data do not support the rationale for offering ovarian ablation therapy to postmenopausal patients with breast cancer, when increased androgen production is proven (Hall and Dederiel, 1959), neither does it help to explain the claim that early oophorectomy significantly reduces the incidence of breast cancer (Feinleib, 1968) There is, however, much evidence of disturbed androgen metabolism in women with breast cancer. For example, there is a decreased level of androsterone and aetiocholanone in urine (Hayward and Bulbrook, 1968;Bulbrook, Hayward and Spicer, 1971). These metabolites are derived from circulating dehydroepiandrosterone sulphate, dehydroepiandrosterone and androstenedione, and are thus primarily of adrenal origin.…”