Hormone Molecular Biology and Clinical Investigation
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Testosterone and risk of breast cancer: appraisal of existing evidence
1Departments of Biochemistry and Urology, Boston University School of Medicine Boston, MA, USA
2Men's Health Center, Miriam Hospital, Providence, RI, USA
3Swansea Family Practice Group, Swansea, MA, USA
4Department of OB/GYN, Stavanger University Hospital, Stavanger, Norway
5Copenhagen Cardiovascular Clinic, Copenhagen, Denmark
6Center for Sexual Function/Endocrinology Lahey Clinic Northshore, Peabody, MA, USA
Citation Information: Hormone Molecular Biology and Clinical Investigation. Volume 2, Issue 1, Pages 177–190, ISSN (Online) 1868-1891, ISSN (Print) 1868-1883, DOI: https://doi.org/10.1515/hmbci.2010.024, May 2010
- Published Online:
The objective of this review was to examine data from preclinical, clinical and epidemiological studies to evaluate if testosterone (T) poses increased risk of breast cancer in women. Appraisal of the existing literature produced several lines of evidence arguing against increased breast cancer risk with T. These include: (i) Data from breast tumor cell lines treated with androgens did not corroborate the notion that T increases breast cancer risk. On the contrary, androgens appear to be protective, as they inhibit tumor cell growth. (ii) Many of the epidemiological studies claiming an association between T and breast cancer did not adjust for estrogen levels. Studies adjusted for estrogen levels reported no association between T and breast cancer. (iii) Data from clinical studies with exogenous androgen treatment of women with endocrine and sexual disorders did not show any increase in incidence of breast cancer. (iv) Women afflicted with polycystic ovary disease, who exhibit high levels of androgens do not show increased risk of breast cancer compared to the general population. (v) Female to male transsexuals, who receive supraphysiological doses of T for long time periods prior to surgical procedures, do not report increased risk of breast cancer. (vi) Finally, women with hormone responsive primary breast cancer are treated with aromatase inhibitors, which block conversion of androgens to estrogens, thus elevating androgen levels. These women do not experience increased incidence of contralateral breast cancer nor do they experience increased tumor growth. In conclusion, the evidence available strongly suggests that T does not increase breast cancer risk in women.
Keywords: androgen excess; androgen therapy; aromatase inhibitors; breast cancer; estradiol; hormone replacement therapy; menopause; polycystic ovary disease; sex hormone binding globulin; testosterone
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