Summary There is evidence that increased oestrogen receptor (ER) expression in normal mammary epithelium may be a risk marker for the development of breast cancer. Insulin-like growth factor 1 (IGF1) is a potent inducer of mitosis and has been shown to synergize with oestrogen in stimulating the growth of human breast cancer in vitro. In these cells oestradiol has been shown to upregulate IGF Khan et al, 1994). ER expression in normal breast tissue is correlated with its proliferative activity and it has been postulated that the mitogenic activity of insulin-like growth factor 1 (IGF1) might interact with that of oestradiol in promoting breast cancer development after the initiation of carcinogenesis (Clarke et al, 1997). It is useful to summarize recent studies attempting to correlate measurements of ER and IGF1 with those of IGFI receptor (IGFR) and binding proteins (IGFBPs) in human breast cancer and in normal mammary epithelium.
IGF1, hyperinsulinaemia and breast cancerA considerable literature has shown that insulin-like growth factors IGF1 and IGF1 1 can stimulate the growth of human breast cancer cell lines in vitro (summarized in Westley and May, 1994).The mitogenic effects of both IGF1 and IGF1 1 are thought to be mediated mainly by their binding to the IGF1 receptor, which is located mainly in the epithelial component of breast cancer (Ellis et al, 1994). Both IGFs are expressed in the stromal component suggesting that they mainly exert a paracrine effect on the epithelium (Singer et al, 1995) but in addition, circulating IGF1 may exert an endocrine effect on breast tissue.It is relevant that hyperinsulinaemia is associated with raised levels of IGF1 and in addition, insulin levels determine the