Testosterone levels in the plasma of normal women and patients with benign breast disease or with breast cancer

Testosterone, dihydrotestosterone and oestradiol levels in postmenopausal breast cancer tissues

The ability of breast tumours to synthesize hormones is well recognized, and local production of sex steroids is thought to play a role in breast cancer growth. We measured the intratumour and circulating levels of testosterone, dihydrotestosterone (DHT) and oestradiol in 35 histologically confirmed carcinomatous mammary tissues obtained at breast surgery from 34 postmenopausal patients, age 50-85 years. Intra-tissue steroids were extracted with ethanol:acetone (1:1; v/v), defatted with 70% methanol in water, and extracted with ether. Steroids, from tissue and serum, were separated by partition chromatography on celite columns and were measured by RIA. Intratumour testosterone and DHT concentrations were significantly correlated, after the exclusion of an outlier (rs = 0.71; P = 0.0001). No association was found between oestradiol and either of the two androgens. Mean oestradiol and DHT concentrations were significantly higher in tissue than in blood (P = 0.0001). Mean testosterone levels in tissues did not significantly differ from those measured in blood. Our data suggest that at least a part of intratissue DHT is produced locally from testosterone. The meaning of high oestradiol and DHT levels in cancer tissue still needs to be defined.

Androgen excretion in women with a family history of breast cancer or with epithelial hyperplasia or cancer of the breast

Urinary testosterone and androstanediol were measured by gas chromatography in four groups of premenopausal subjects: 22 healthy women (control group), 21 healthy women with a family history of breast cancer (familiality group), 39 patients with breast lumps which consisted of ductal or lobular hyperplasia (hyperplasia group) and 18 patients with infiltrating breast carcinoma (carcinoma group). On the basis of normal values found in our laboratory, steroid levels were above normal in 4.5% of the controls, 4.7% of the familiality group, 38.5% of the hyperplasia group (P less than 0.01 vs controls) and 61.1% of the carcinoma group (P less than 0.001 vs control group). The mean testosterone level in the carcinoma group (11.3 +/- 6.78 S.D.) and the mean androstanediol level in the hyperplasia group (47.25 +/- 31.0 S.D.) were significantly higher than those of the control group (testosterone 6.25 +/- 3.48 S.D., androstanediol 32.55 +/- 20.0 S.D.). No significant difference was found in mean testosterone or androstanediol levels between the control group and the familiality group (testerone 5.41 +/- 3.6 S.D., androstanediol 29.38 +/- 15.89 S.D.). We conclude that increased excretion of androgenic steroids is a hormonal abnormality common to breast cancer patients and to patients with breast epithelial hyperplasia, but not to subjects with a family history of carcinoma of the breast.

Age-related changes in sebaceous gland activity

The sebaceous glands of man show age-related differences in their activity as determined by quantitative and qualitative examination of sebum. Sebaceous secretion is low in children and begins to increase in mid- to late childhood under the influence of androgens. This rise continues until the late teens, after which no further significant change takes place until late in life. In elderly men, sebum levels remain essentially unchanged from those of younger adults until the age of 80. In women, sebaceous secretion decreases gradually after menopause and shows no significant change after the 7th decade. The most likely explanation for the decrease in sebaceous gland secretion with age in both men and women is a concomitant decrease in the endogenous production of androgens. Although surface lipid levels fall with age, paradoxically the sebaceous glands become larger, rather than smaller, as a result of decreased cellular turnover. Nonetheless, as the higher surface lipid levels after administration of fluoxymesterone (a synthetic testosterone derivative) indicate, the glands have the capacity to respond to androgens.

Serum concentrations of estrone, androstenedione, testosterone and sex-hormone-binding globulin in postmenopausal women with breast cancer and in age-matched controls

The concentrations of estrone (E1), androstenedione (A), testosterone (T) and sex-hormone-binding globulin (SHBG) in the serum were determined in 122 postmenopausal women, unselected with respect to age and stage of disease and with a newly diagnosed breast cancer. The results were compared with those in 122 age-matched women without breast cancer, selected from the population register. The patients were found to have a significantly higher mean level than the controls of E1 (132 and 108 pmol/l), A (2.5 and 1.6 nmol/l) and T (1.54 and 1.38 nmol/l) and a lower level of SHBG (40.2 and 47.3 nmol/l) in the serum. A multiple regression analysis revealed in the control group that the serum level of E1 was significantly correlated to A (r = 0.48, p less than 0.001) and T (r = 0.45, p less than 0.001). In the patient group E1 was only slightly correlated to T (r = 0.25, p less than 0.01) and not to A (r = 0.10, p greater than 0.05). A significant negative correlation was found between SHBG and weight in both groups. Otherwise no significant correlations were found between any of the hormone levels and age, stage of disease of weight. It was concluded that an increased availability of A and T, leading to an increased androgenic stimulation--and therefore decreased SHBG--and an increased E1 level, is the most reasonable explanation for the findings. The lack of correlation between E1 and A in the patient group is however difficult to explain and the results do not seem to fit into a definite hypothesis.