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Medical Forum / General / General / December 2004

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Testosterone added to Estrogen/Progestin Therapy reduces breast cancer risk toward baseline

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William_Noyes - 02 Dec 2004 22:26 GMT
This isn't the only piece of evidence of the value of androgens/testosterone
therapy in women. But it makes it clear the testosterone isn't only
about sexual pleasure but also about life. If ERT regimens were no
longer a risk breast cancer, they'd be more useful. Even taken alone
androgen therapy for some women appears useful.

Please consider the following and comment:

2: Menopause. 2004 Sep-Oct;11(5):531-5.

Breast cancer incidence in postmenopausal women using
testosterone in addition to usual hormone therapy.

Dimitrakakis C, Jones RA, Liu A, Bondy CA.

Developmental Endocrinology Branch, National Institute of
Child Health and Human Development,
National Institutes of Health, Bethesda, MD 20892, USA.

OBJECTIVE: There is now convincing evidence that usual
hormone therapy for ovarian failure increases the risk for
breast cancer. We have previously shown that ovarian
androgens normally protect mammary epithelial cells from
excessive estrogenic stimulation, and therefore we
hypothesized that the addition of testosterone to usual
hormone therapy might protect women from breast
cancer.

DESIGN: This was a retrospective, observational study that
followed 508 postmenopausal women receiving testosterone
in addition to usual hormone therapy in South Australia.
Breast cancer status was ascertained by mammography at
the initiation of testosterone treatment and biannually thereafter.
The average age at the start of follow-up was 56.4 years,
and the mean duration of follow-up was 5.8 years.
Breast cancer incidence in this group was compared with
that of untreated women and women using usual
hormone therapy reported in the medical
literature and to age-specific local population rates.

RESULTS: There were seven cases of invasive
breast cancer in this population of testosterone users,
for an incidence of 238 per 100,000 woman-years.
The rate for estrogen/progestin and
testosterone users was 293 per 100,000
woman-years--substantially less than women receiving
estrogen/pro-gestin in the Women's Health Initiative study
(380 per 100,000 woman-years) or in the "Million
Women" Study (521 per 100,000 woman-years).
The breast cancer rate in our testosterone users was closest
to that reported for hormone therapy never-users in
the latter study (283 per 100,000 woman-years), and
their age-standardized rate was the same as for
the general population in South Australia.

CONCLUSIONS: These observations suggest
that the addition of testosterone to conventional hormone
therapy for postmenopausal women does not increase
and may indeed reduce the hormone therapy-associated
breast cancer risk-thereby returning the incidence to the
normal rates observed in the general, untreated population.

PMID: 15356405 [PubMed - in process]

Pubmed search words were "estrogen testosterone cancer"
as I recall. I may have also used the word "therapy", "androgens",
and "breast" in related searchs.
James Michael Howard - 02 Dec 2004 22:43 GMT
>This isn't the only piece of evidence of the value of androgens/testosterone
>therapy in women. But it makes it clear the testosterone isn't only
[quoted text clipped - 63 lines]
>as I recall. I may have also used the word "therapy", "androgens",
>and "breast" in related searchs.

I would be careful giving testosterone to women: This is just a
sample.  Look between the ****** below.

Int J Cancer. 2005 Jan 20;113(3):499-502. Related Articles, Links  

 
Serum testosterone levels and breast cancer recurrence.

Berrino F, Pasanisi P, Bellati C, Venturelli E, Krogh V, Mastroianni
A, Berselli E, Muti P, Secreto G.

Department of Preventive and Predictive Medicine, Istituto Nazionale
Tumori, Milan, Italy.

Prospective studies show that high serum levels of androgens and
estrogens are associated with increased incidence of postmenopausal
breast cancer. The aim of the present analysis was to study the
prognostic value of serum testosterone, estradiol and related factors
in postmenopausal breast cancer patients. One hundred and ten patients
without clinical recurrence were included in the study. After 5.5
years of follow-up, 31 patients developed distant metastasis (16),
local relapse (4), or contralateral breast cancer (11). The risk of
adverse events in relation to hormone level was examined by Cox'
proportional hazard modeling, adjusting for hormone receptor status
and stage at diagnosis. Body mass index and serum levels of
testosterone, estradiol and glucose were significantly higher in
patients who recurred than those who did not. The hazard ratios were
1.8 (95% CI = 0.5-6.3) for the middle and 7.2 (95% CI = 2.4-21.4) for
the upper tertiles of baseline testosterone distribution. Other
hormones had only minor influence on prognosis. ******High
testosterone predicts breast cancer recurrence.****** Further studies
are required to determine whether dietary or other medical
intervention to reduce testosterone can reduce the recurrence of
breast cancer.

Int J Cancer. 2004 Nov 1;112(2):312-8. Related Articles, Links  

 
Endogenous sex hormones and subsequent breast cancer in premenopausal
women.

Micheli A, Muti P, Secreto G, Krogh V, Meneghini E, Venturelli E,
Sieri S, Pala V, Berrino F.

Unita di Epidemiologia, Istituto Nazionale per lo Studio e la Cura dei
Tumori, Milano, Italy.

Because of large intra-individual variation in hormone levels, few
studies have investigated the relation of serum sex hormones to breast
cancer (BC) in premenopausal women. We prospectively studied this
relation, adjusting for timing of blood sampling within menstrual
cycle. Premenopausal women (5,963), recruited to the Hormones and Diet
in the Etiology of Breast Tumors (ORDET) cohort study, provided a
blood sample in the 20-24th day of their menstrual cycle. After 5.2
years of follow-up, 65 histologically confirmed BC cases were
identified and matched individually to 4 randomly selected controls.
Sera, stored at -80 degrees C, were assayed blindly for
dehydroepiandrosterone sulfate, total and free testosterone (FT),
androstenedione, androstanediol-glucoronide, progesterone,
17-OH-progesterone, sex hormone-binding globulin, follicle-stimulating
hormone (FSH) and luteinizing hormone (LH). Fifty-five cases had
information for multivariate analyses. Compared to controls, BC cases
had shorter cycles and intervals between blood sampling and bleeding,
and lower LH and FSH. FT was significantly associated with BC risk:
relative risk (RR; adjusted for age, body mass index and ovarian cycle
variables) of highest vs. lowest tertile was 2.85 [95% confidence
interval (CI) = 1.11-7.33, p for trend = 0.030]. Progesterone was
inversely associated with adjusted RR for highest vs. lowest tertile
of 0.40 (95% CI = 0.15-1.08, p for trend = 0.077), significantly so in
women with regular menses, where adjusted RR was 0.12 (95% CI =
0.03-0.52, p for trend = 0.005). *****These findings support the
hypothesis that ovarian hyperandrogenism associated with luteal
insufficiency increases the risk of BC in premenopausal women.*****
Copyright 2004 Wiley-Liss, Inc.
William_Noyes - 02 Dec 2004 23:07 GMT
It would wise to check for elevated androgen levels.
The idea with androgen therapy is to replace it up to normal healthy young
adult levels.
And the androgen may not need to be teostosterone.
It may also be that unopposed T therapy has some downsides
as does unopposed E therapy has some downsides.These downsides
are apparently neutralized with concurrent E and T therapy at least
in some.

> I would be careful giving testosterone to women: This is just a
> sample.  Look between the ****** below.
[quoted text clipped - 68 lines]
> insufficiency increases the risk of BC in premenopausal women.*****
> Copyright 2004 Wiley-Liss, Inc.
William_Noyes - 02 Dec 2004 22:48 GMT
This isn't the only piece of evidence of the value of
androgens/testosterone
therapy in women. But it makes it clear the testosterone isn't only
about sexual pleasure but also about life. If ERT regimens were no
longer a risk breast cancer, they'd be more useful. Even taken alone
androgen therapy for some women appears useful.

Hormone therapy is a great idea which conventional medicine seems
have gone out of it way to botch or deny. What is the systemic problem that
permits this state of affairs?

Please consider the following and comment:

2: Menopause. 2004 Sep-Oct;11(5):531-5.

Breast cancer incidence in postmenopausal women using
testosterone in addition to usual hormone therapy.

Dimitrakakis C, Jones RA, Liu A, Bondy CA.

Developmental Endocrinology Branch, National Institute of
Child Health and Human Development,
National Institutes of Health, Bethesda, MD 20892, USA.

OBJECTIVE: There is now convincing evidence that usual
hormone therapy for ovarian failure increases the risk for
breast cancer. We have previously shown that ovarian
androgens normally protect mammary epithelial cells from
excessive estrogenic stimulation, and therefore we
hypothesized that the addition of testosterone to usual
hormone therapy might protect women from breast
cancer.

DESIGN: This was a retrospective, observational study that
followed 508 postmenopausal women receiving testosterone
in addition to usual hormone therapy in South Australia.
Breast cancer status was ascertained by mammography at
the initiation of testosterone treatment and biannually thereafter.
The average age at the start of follow-up was 56.4 years,
and the mean duration of follow-up was 5.8 years.
Breast cancer incidence in this group was compared with
that of untreated women and women using usual
hormone therapy reported in the medical
literature and to age-specific local population rates.

RESULTS: There were seven cases of invasive
breast cancer in this population of testosterone users,
for an incidence of 238 per 100,000 woman-years.
The rate for estrogen/progestin and
testosterone users was 293 per 100,000
woman-years--substantially less than women receiving
estrogen/pro-gestin in the Women's Health Initiative study
(380 per 100,000 woman-years) or in the "Million
Women" Study (521 per 100,000 woman-years).
The breast cancer rate in our testosterone users was closest
to that reported for hormone therapy never-users in
the latter study (283 per 100,000 woman-years), and
their age-standardized rate was the same as for
the general population in South Australia.

CONCLUSIONS: These observations suggest
that the addition of testosterone to conventional hormone
therapy for postmenopausal women does not increase
and may indeed reduce the hormone therapy-associated
breast cancer risk-thereby returning the incidence to the
normal rates observed in the general, untreated population.

PMID: 15356405 [PubMed - in process]

Pubmed search words were "estrogen testosterone cancer"
as I recall. I may have also used the word "therapy", "androgens",
and "breast" in related searchs.
 
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