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CC-BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(01): 14-20
DOI: 10.1055/s-0036-1597974
Original Article
Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

Estrone and Estradiol Levels in Breast Cancer Patients Using Anastrozole Are Not Related to Body Mass Index

Níveis de estrona e estradiol em pacientes com câncer de mama usando anastrozol não estão relacionados ao índice de massa corpórea
Eduardo Borges Coscia
1   Department of Pharmaceutical Sciences, Universidade de Sorocaba, Sorocaba, São Paulo, Brazil
,
Maricene Sabha
1   Department of Pharmaceutical Sciences, Universidade de Sorocaba, Sorocaba, São Paulo, Brazil
,
Marli Gerenutti
1   Department of Pharmaceutical Sciences, Universidade de Sorocaba, Sorocaba, São Paulo, Brazil
,
Francisco Carlos Groppo
2   Department of Pharmacology, Anesthesiology and Therapeutics, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, Brazil
,
Cristiane de Cássia Bergamaschi
1   Department of Pharmaceutical Sciences, Universidade de Sorocaba, Sorocaba, São Paulo, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

12. April 2016

08. November 2016

Publikationsdatum:
10. Februar 2017 (online)

  Lizenzen und Reprints

Abstract

Objective Obesity is associated with an increased risk for breast cancer. Recent studies have shown that aromatase inhibitors may be less effective in women with a high body mass index (BMI). The aim of this study was to establish the relationship between the BMI and plasma estrone and estradiol levels in postmenopausal women with hormone receptor-positive breast cancer using anastrozole.

Methods In this cohort study, the patients were divided into three groups according to BMI (normal weight, overweight and obese) to compare and correlate plasma hormone levels before starting anastrozole hormone therapy and three months after treatment. Plasma hormone levels were compared for age and use of chemotherapy.

Results A statistically significant reduction in estrone and estradiol levels was observed between baseline and three months after starting the anastrozole treatment (p < 0.05). There was no statistically significant difference in plasma estrone and estradiol levels among the BMI groups (p > 0.05), but a significant reduction in plasma estrone levels was observed after three-months' treatment relative to baseline in all groups, as well as a reduction in estradiol in the obese group (p < 0.05). The use of chemotherapy and age > 65 years had no influence on plasma steroid levels.

Conclusion Changes in estrone and estradiol levels in the studied groups were not associated with BMI, chemotherapy or age.

Resumo

Objetivo A obesidade está associada com risco aumentado de câncer de mama. Estudos recentes têm mostrado que os inibidores de aromatase podem ser menos eficazes em mulheres com alto índice de massa corporal (IMC). O objetivo deste estudo foi estabelecer a relação entre o IMC e os níveis plasmáticos de estrona e estradiol em mulheres no período pós-menopausa com câncer de mama receptor hormonal positivo, em tratamento com anastrozol.

Métodos Este estudo de coorte acompanhou três grupos de pacientes de acordo com o seu IMC (peso normal, sobrepeso e obesidade), a fim de comparar e correlacionar as dosagens dos hormônios estrona e estradiol antes e após três meses do uso do anastrozol. Os níveis plasmáticos dos hormônios foram também relacionados à idade do paciente e ao uso da quimioterapia.

Resultados Redução estatisticamente significativa de estrona e estradiol foi observada entre os níveis basais e três meses após o início do tratamento com anastrozol (p < 0,05). Não houve diferença estatisticamente significativa entre os níveis plasmáticos de estrona e estradiol em relação ao IMC (p > 0,05), mas houve redução significativa entre os níveis plasmáticos basais de estrona após o tratamento em todos os grupos, e redução de estradiol no grupo de pacientes obesas (p < 0,05). A condução da quimioterapia e da idade acima de 65 anos não interfere com os níveis plasmáticos de esteroides.

Conclusão Os níveis plasmáticos de estrona e estradiol nos grupos estudados não foram alterados em termos de IMC, quimioterapia e idade.

Keywords

breast neoplasms - estrone - estradiol - body mass index - anastrozole

Palavras-chave

neoplasias de mama - estrona - estradiol - índice de massa corporal - anastrozol
 

  • References

  • 1 Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva. [Estimate 2014: cancer incidence in Brazil]. Rio de Janeiro: INCA; 2014
    Suche in Google Scholar
  • 2 Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin 2012; 62 (01) 10-29
    CrossrefPubMedSuche in Google Scholar
  • 3 Vogel VG. Epidemiology, genetics, and risk evaluation of postmenopausal women at risk of breast cancer. Menopause 2008; 15 (4, Suppl) 782-789
    CrossrefPubMedSuche in Google Scholar
  • 4 Cintra KA, Mattar A, Joo YK, Melitto A, Waitzberg AFL, Gebrim LH. Correlation between anthropometric measurements and lymph node metastases in postmenopausal women with breast cancer. Rev Bras Mastol 2010; 20 (03) 122-125
    PubMedSuche in Google Scholar
  • 5 Friedenreich CM. Review of anthropometric factors and breast cancer risk. Eur J Cancer Prev 2001; 10 (01) 15-32
    CrossrefPubMedSuche in Google Scholar
  • 6 Folkerd EJ, Dixon JM, Renshaw L, A'Hern RP, Dowsett M. Suppression of plasma estrogen levels by letrozole and anastrozole is related to body mass index in patients with breast cancer. J Clin Oncol 2012; 30 (24) 2977-2980
    CrossrefPubMedSuche in Google Scholar
  • 7 McTiernan A, Rajan KB, Tworoger SS. , et al. Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol 2003; 21 (10) 1961-1966
    CrossrefPubMedSuche in Google Scholar
  • 8 Colditz GA, Rosner BA, Chen WY, Holmes MD, Hankinson SE. Risk factors for breast cancer according to estrogen and progesterone receptor status. J Natl Cancer Inst 2004; 96 (03) 218-228
    CrossrefPubMedSuche in Google Scholar
  • 9 Suzuki R, Orsini N, Saji S, Key TJ, Wolk A. Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status--a meta-analysis. Int J Cancer 2009; 124 (03) 698-712
    CrossrefPubMedSuche in Google Scholar
  • 10 Diorio C, Lemieux J, Provencher L, Hogue JC, Vachon E. Aromatase inhibitors in obese breast cancer patients are not associated with increased plasma estradiol levels. Breast Cancer Res Treat 2012; 136 (02) 573-579
    CrossrefPubMedSuche in Google Scholar
  • 11 Saad ED, Bromberg S, Katz A, Simon SD. Aromatase inhibitors in breast cancer: from metastatic disease to adjuvant treatment. Rev Bras Cancerol 2002; 48 (04) 555-567
    PubMedSuche in Google Scholar
  • 12 Dixon JM, Renshaw L, Young O. , et al. Letrozole suppresses plasma estradiol and estrone sulphate more completely than anastrozole in postmenopausal women with breast cancer. J Clin Oncol 2008; 26 (10) 1671-1676
    CrossrefPubMedSuche in Google Scholar
  • 13 Dowsett M, Donaldson K, Tsuboi M, Wong J, Yates R. Effects of the aromatase inhibitor anastrozole on serum oestrogens in Japanese and Caucasian women. Cancer Chemother Pharmacol 2000; 46 (01) 35-39
    CrossrefPubMedSuche in Google Scholar
  • 14 Sestak I, Distler W, Forbes JF, Dowsett M, Howell A, Cuzick J. Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial. J Clin Oncol 2010; 28 (21) 3411-3415
    CrossrefPubMedSuche in Google Scholar
  • 15 Goodwin PJ, Pritchard KI. Obesity and hormone therapy in breast cancer: an unfinished puzzle. J Clin Oncol 2010; 28 (21) 3405-3407
    CrossrefPubMedSuche in Google Scholar
  • 16 Sexton KR, Franzini L, Day RS, Brewster A, Vernon SW, Bondy ML. A review of body size and breast cancer risk in Hispanic and African American women. Cancer 2011; 117 (23) 5271-5281
    CrossrefPubMedSuche in Google Scholar
  • 17 National Cancer Institute. Breast cancer treatment. Washington (DC): U.S. Department of Health & Human Services; 2013
    Suche in Google Scholar
  • 18 Baum M, Budzar AU, Cuzick J. , et al; ATAC Trialists' Group. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet 2002; 359 (9324): 2131-2139
    CrossrefPubMedSuche in Google Scholar
  • 19 Eisen A, Trudeau M, Shelley W, Messersmith H, Pritchard KI. Aromatase inhibitors in adjuvant therapy for hormone receptor positive breast cancer: a systematic review. Cancer Treat Rev 2008; 34 (02) 157-174
    CrossrefPubMedSuche in Google Scholar
  • 20 Buzdar AU. Pharmacology and pharmacokinetics of the newer generation aromatase inhibitors. Clin Cancer Res 2003; 9 (1 Pt 2): 468S-472S
    PubMedSuche in Google Scholar
  • 21 Sanford M, Plosker GL. Anastrozole: a review of its use in postmenopausal women with early-stage breast cancer. Drugs 2008; 68 (09) 1319-1340
    CrossrefPubMedSuche in Google Scholar
  • 22 Dixon JM, Renshaw L, Bellamy C, Stuart M, Hoctin-Boes G, Miller WR. The effects of neoadjuvant anastrozole (Arimidex) on tumor volume in postmenopausal women with breast cancer: a randomized, double-blind, single-center study. Clin Cancer Res 2000; 6 (06) 2229-2235
    PubMedSuche in Google Scholar
  • 23 Smith IE, Dowsett M, Ebbs SR. , et al; IMPACT Trialists Group. Neoadjuvant treatment of postmenopausal breast cancer with anastrozole, tamoxifen, or both in combination: the Immediate Preoperative Anastrozole, Tamoxifen, or Combined with Tamoxifen (IMPACT) multicenter double-blind randomized trial. J Clin Oncol 2005; 23 (22) 5108-5116
    CrossrefPubMedSuche in Google Scholar
  • 24 Hankinson SE. Endogenous hormones and risk of breast cancer in postmenopausal women. Breast Dis 2005; –2006–2006: 24: 3-15
    CrossrefPubMedSuche in Google Scholar
  • 25 Kaaks R, Rinaldi S, Key TJ. , et al. Postmenopausal serum androgens, oestrogens and breast cancer risk: the European prospective investigation into cancer and nutrition. Endocr Relat Cancer 2005; 12 (04) 1071-1082
    CrossrefPubMedSuche in Google Scholar
  • 26 Lønning PE, Haynes BP, Dowsett M. Relationship of body mass index with aromatisation and plasma and tissue oestrogen levels in postmenopausal breast cancer patients treated with aromatase inhibitors. Eur J Cancer 2014; 50 (06) 1055-1064
    CrossrefPubMedSuche in Google Scholar
  • 27 Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 2010; 123 (03) 627-635
    CrossrefPubMedSuche in Google Scholar
  • 28 Prentice AM, Jebb SA. Beyond body mass index. Obes Rev 2001; 2 (03) 141-147
    CrossrefPubMedSuche in Google Scholar
  • 29 Key TJ, Appleby PN, Reeves GK. , et al; Endogenous Hormones Breast Cancer Collaborative Group. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst 2003; 95 (16) 1218-1226
    CrossrefPubMedSuche in Google Scholar
  • 30 Carmichael AR, Bates T. Obesity and breast cancer: a review of the literature. Breast 2004; 13 (02) 85-92
    CrossrefPubMedSuche in Google Scholar
  • 31 Cleary MP, Grossmann ME. Minireview: Obesity and breast cancer: the estrogen connection. Endocrinology 2009; 150 (06) 2537-2542
    CrossrefPubMedSuche in Google Scholar
  • 32 Murphy CC, Bartholomew LK, Carpentier MY, Bluethmann SM, Vernon SW. Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat 2012; 134 (02) 459-478
    CrossrefPubMedSuche in Google Scholar
  • 33 Danilak M, Chambers CR. Adherence to adjuvant endocrine therapy in women with breast cancer. J Oncol Pharm Pract 2013; 19 (02) 105-110
    CrossrefPubMedSuche in Google Scholar