Plasma testosterone and prognosis of postmenopausal breast cancer patients

Andrea Micheli, Elisabetta Meneghini, Giorgio Secreto, Franco Berrino, Elisabetta Venturelli, Adalberto Cavalleri, Tiziana Camerini, Maria G. Di Mauro, Elena Cavadini, Giuseppe De Palo, Umberto Veronesi, Franca Formelli

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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°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 (≥ 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.

Original languageEnglish
Pages (from-to)2685-2690
Number of pages6
JournalJournal of Clinical Oncology
Volume25
Issue number19
DOIs
Publication statusPublished - Jul 1 2007

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Testosterone
Breast Neoplasms
Disease-Free Survival
Fenretinide
Neoplasms
Proportional Hazards Models
Histology
Recurrence
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Micheli, A., Meneghini, E., Secreto, G., Berrino, F., Venturelli, E., Cavalleri, A., ... Formelli, F. (2007). Plasma testosterone and prognosis of postmenopausal breast cancer patients. Journal of Clinical Oncology, 25(19), 2685-2690. https://doi.org/10.1200/JCO.2006.09.0118

Plasma testosterone and prognosis of postmenopausal breast cancer patients. / Micheli, Andrea; Meneghini, Elisabetta; Secreto, Giorgio; Berrino, Franco; Venturelli, Elisabetta; Cavalleri, Adalberto; Camerini, Tiziana; Di Mauro, Maria G.; Cavadini, Elena; De Palo, Giuseppe; Veronesi, Umberto; Formelli, Franca.

In: Journal of Clinical Oncology, Vol. 25, No. 19, 01.07.2007, p. 2685-2690.

Research output: Contribution to journalArticle

Micheli, A, Meneghini, E, Secreto, G, Berrino, F, Venturelli, E, Cavalleri, A, Camerini, T, Di Mauro, MG, Cavadini, E, De Palo, G, Veronesi, U & Formelli, F 2007, 'Plasma testosterone and prognosis of postmenopausal breast cancer patients', Journal of Clinical Oncology, vol. 25, no. 19, pp. 2685-2690. https://doi.org/10.1200/JCO.2006.09.0118
Micheli A, Meneghini E, Secreto G, Berrino F, Venturelli E, Cavalleri A et al. Plasma testosterone and prognosis of postmenopausal breast cancer patients. Journal of Clinical Oncology. 2007 Jul 1;25(19):2685-2690. https://doi.org/10.1200/JCO.2006.09.0118
Micheli, Andrea ; Meneghini, Elisabetta ; Secreto, Giorgio ; Berrino, Franco ; Venturelli, Elisabetta ; Cavalleri, Adalberto ; Camerini, Tiziana ; Di Mauro, Maria G. ; Cavadini, Elena ; De Palo, Giuseppe ; Veronesi, Umberto ; Formelli, Franca. / Plasma testosterone and prognosis of postmenopausal breast cancer patients. In: Journal of Clinical Oncology. 2007 ; Vol. 25, No. 19. pp. 2685-2690.
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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°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 (≥ 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.",
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N2 - 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°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 (≥ 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.

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