gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Postmenopausal serum sex steroids and risk of hormone receptor positive and negative breast cancer: a nested case-control study

Meeting Abstract

  • Rebecca James - DKFZ, Heidelberg
  • Annekatrin Lukanova - DKFZ, Heidelberg
  • Laure Dossus - DKFZ, Heidelberg
  • Susen Becker - Universitätsklinikum Leipzig, Leipzig
  • Sabina Rinaldi - IARC, Lyon
  • Rudolf Kaaks - DKFZ, Heidelbeg

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds215

doi: 10.3205/11gmds215, urn:nbn:de:0183-11gmds2157

Published: September 20, 2011

© 2011 James et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Pre-diagnostic endogenous sex steroid hormone levels have well established associations with overall risk of breast cancer. While evidence towards the existence of distinct subtypes of breast cancer accumulates, few studies have investigated the associations of sex steroid hormone levels with risk of hormone receptor (estrogen (ER) and/or progesterone receptor (PR)) defined breast cancer.

Methods: In a case-control study nested within the EPIC cohort (European Prospective Investigation into Cancer and Nutrition), estradiol, testosterone and sex hormone binding globulin levels were measured in pre-diagnostic serum samples from postmenopausal women not using hormone replacement therapy at blood donation. 554 women who developed invasive breast cancer with information on receptor status were matched with 821 control subjects. Conditional logistic regression models estimated breast cancer risk with hormone concentrations according to hormone receptor status of the tumor.

Results: Sex steroid hormones were associated with risks of not only ER+PR+ breast cancer [estradiol OR for highest versus lowest tertile=2.91 (95%CI:1.62-5.23), Ptrend0.002; testosterone OR=2.27 (95%CI:1.35-3.81), Ptrend=0.002] but also of ER-PR- breast cancer [estradiol OR=2.11 (95%CI:1.00-4.46), Ptrend =0.05; testosterone OR=2.06 (95%CI:0.95-4.46), Ptrend=0.03], with associations appearing somewhat stronger in the receptor positive disease.

Conclusions: The widely reported associations of estradiol and its androgenic precursors with overall postmenopausal breast cancer risk were not statistically heterogeneous between receptor positive tumors and hormone receptor negative breast cancer. Estrogens may not only have late-stage effects on growth promotion of tumors (especially of ER-positive type) but probably also play an important role in earlier evolutionary stages of development. Further research is needed to establish through which molecular pathways, and during which evolutionary stages of development, androgens and estrogens can promote the occurrence of both receptor-positive and –negative clinical breast tumors.