Urinary 11-deoxy-17-ketosteroids in Breast Cancer Patients considered in Relation to the Menstrual Cycle: Ovulatory and non ovulatory

Increased Androgenic Activity as an Etiologic Factor of Human Breast Cancer

In our previous study (4) we showed that anovulatory menstrual cycles combined with a hyperplastic endometrium are very common in premenopausal breast cancer patients. We showed (5) that endometrial hyperplasia is accompanied by increased androgenic activity as shown by the 11-deoxy-17-ketosteroid (etiocholanolone, androsterone) excretion values; it has been shown in other studies (7, 8) that when a hyperplastic endometrial pattern is present in premenopausal breast cancer patients the excretion level of 11-deoxy-17-ketosteroids is even higher than in women without breast cancer but with a hyperplastic endometrium. In the present study we determined the urinary excretion level of testosterone in breast cancer premenopausal and postmenopausal patients and found it significantly higher than the normal control value, which is further proof that an abnormal androgenic activity must play an etiologic role in the development of breast cancer. Such increased androgenic activity observed in women with breast cancer has an ovarian origin; some of these patients were given human chorionic gonadotropin and, when an increase of urinary testosterone followed, the ovaries were resected. Histological examination of the resected ovaries disclosed interstitial cell hyperplasia. The same gonadotropic treatment did not induce an increase of androgenic activity in ovariectomized women (5).