Peripheral metabolism of 3H-estradiol and the excretion of endogenous estrone and estriol glucosiduronate in women with breast cancer

Leon Hellman, Barnett Zumoff, Jack Fishman, T. F. Gallagher

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

Twenty-three women with breast cancer, of varying age and disease status, were given intravenous tracers of 3H-estradiol and the metabolism of the tracer was compared with that of 12 normal women (6 young women aged 21- 32, and 6 elderly women aged 63-80). Estriol constituted an average of 20 % of the glucosiduronate extract in the women with breast cancer, nearly twice the normal average of 12 %. The difference between the group means was highly significant (p<.001) and 11 of the 23 patients had values greater than the upper 95% confidence limit of normal (i.e., 2.6-5.0 standard deviations above the normal mean). Three women with long-term "cure" of breast cancer after mastectomy formed estriol to the extent of 35, 16 and 10 % of the neutral extract. The mean recovery of 2-hydroxyestrone was slightly, but not significantly, lower than normal in the women with breast cancer. Recovery of estrone, estradiol, 2- methoxyestrone and 16-epiestriol was the same in patients and controls. Endogenous urinary estrone and estriol glucosiduronate were determined by double-isotope-derivative analysis in 10 post-menopausal women with breast cancer and in the 6 normal elderly women. The mean endogenous estrone glucosiduronate excretion of the patients was somewhat higher than that of the controls, but the difference was not statistically significant. The endogenous estriol glucosiduronate excretion of the breast cancer patients averaged 5.7 µg daily, more than twice the mean normal value of 2.5 µg daily. The difference between the group means was not statistically significant but 4 of the 10 breast cancer patients had estriol excretion higher than the upper 95 % confidence limit of the normal group (2.5, 4.1, 5.9 and 9.5 standard deviations above the normal mean). It is concluded that about half the patients studied formed significantly greater than normal quantities of estriol from radioactive estradiol tracers or from endogenous precursors. No evidence was found for a group of breast cancer patients who excrete subnormal amounts of estriol. The observed metabolic aberration in some women with breast cancer is qualitatively similar to that previously described in all men with breast cancer. Possible hypotheses to account for these findings are discussed.

Original languageEnglish
Pages (from-to)138-144
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume33
Issue number1
DOIs
StatePublished - 1971
Externally publishedYes

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