The Role of Hormones in the Etiology of Breast and Endometrial Cancer

Abstract

Despite many years of extensive investigation, there has been neither a clear-cut pattern of hormonal production nor milieu found in women with breast cancer. Estrogen replacement therapy for menopause does not significantly increase the risk of breast cancer and one study indicated that estrogen users have a lower incidence of breast cancer than that observed in untreated women. Some studies have shown that the mortality rate from breast cancer is lower in estrogen-treated postmenopausal women. Only one investigator has found any significantly increased risk of breast cancer in oral contraceptive users. In that report, increased duration of birth control pill use decreased the risk of breast carcinoma. Several studies were unable to find an increased risk of breast cancer from oral contraceptives while one investigation observed a lower incidence in birth control pill users than that expected. The mortality from carcinoma of the breast in oral contraceptive users was lower than in non-users, most likely due to earlier detection. Although some retrospective studies have indicated that estrogen use increases the risk of endometrial cancer, a prospective investigation found only an insignificant increase. Progestogens afford some protection from cancer in estrogen-treated postmenopausal women. The incidence of endometrial adenocarcinoma is lower than that observed in untreated postmenopausal women. Combination oral contraceptives are protective against developing adenocarcinoma of the endometrium but sequential birth control pills may afford less protection. Suppl. 88 (1 979) Acta Obstet Gynecol Scand

The Impact of Obesity on the Incidence and Treatment of Gynecologic Cancers: A Review

“…Of primary importance is the profound change in the hormonal milieu of overweight and obese women. A basic summary of these hormonal changes is as follows: 1) increased estrogen levels through conversion of circulating androgens through increased aromatase activity in peripheral adipocytes (6,15,(21)(22)(23)(24)(25); 2) increased adrenal and ovarian secretion of androgens (21,23,26); 3) increased free steroid hormone levels secondary to decreased sex hormone binding globulin (SHBG) production (25,27); and 4) decreased progesterone production in premenopausal women secondary to decreased ovulation (21,28,29). The net result is an increased unopposed estrogen effect in obese women that can promote cancer in hormonally responsive tissues.…”

A Case-Control Study of Endometrial Cancer in Relation to Reproductive, Somatometric, and Life-Style Variables

“…However, the known risk factors do not explain the substantial international vari ability of the disease, nor do they allow reliable predic tions of the disease risk within population groups. Vari ables that have been suggested but not conclusively estab lished as risk factors are height [6,15], primary infertility [16], and age at menarche [5,6], whereas there is little information concerning the potential importance of phys ical activity, coffee intake, miscarriages, or induced abor tions. We have undertaken a study in Athens, Greece, in order to clarify the role of these factors and to assess the effect of the qualitative composition of diet on the occur rence of endometrial cancer.…”

Oral Replacement with Estradiol-Cyclooctyl Acetate: A New Estradiol Analogue

“…Estrogens, most frequently non-alkylated, are widely used in the treatment of climac teric estrogen-deficiency symptoms, com monly combined with progestins to protect the endometrium [1,2], Estrogen-induced side effects are dose-related [3]. By using a parenteral route of administration the clini cal effects may be accomplished with lower doses.…”