Urinary estrogen metabolites and breast cancer: Differential pattern of risk found with pre- versus post-treatment collection

Jay Fowke, Dai Qi, H. Leon Bradlow, Xiao Ou Shu, Yu Tang Gao, Jin Rong Cheng, Fan Jin, Wei Zheng

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Introduction: The products of estrogen metabolism may affect breast carcinogenesis. The 16α-hydroxyestrone (16-OHE) metabolite has a higher affinity for the estrogen receptor (ER) than the 2-hydroxyestrone (2-OHE) metabolite, while conjugated 2-OHE metabolite may inhibit angiogenesis. We investigated the association between the relative concentrations of these metabolites in urine (2-OHE/16-OHE) and breast cancer in a case-control study of Chinese women living in Shanghai. Methods: Incident breast cancer cases between 25 and 65 years of age (n=110) were identified from hospital or population tumor registries in Shanghai, China. Controls (n=110) were randomly selected from a complete registry of the Shanghai population, and individually matched to cases by menopausal status, age, and pre-treatment or post-treatment urine collection time. Urine samples were collected prior to any breast cancer treatment or surgery among 78 case-control pairs, while urine was collected after surgery, and perhaps other treatments, among 32 case-control pairs. A commercial enzyme-immunoassay kit was used to measure urinary estrogen metabolite concentrations. Conditional logistic regression was used to calculate odds ratios summarizing the 2-OHE/16-OHE and breast cancer association within subjects providing either pre-treatment or post-treatment urine samples. Results: Subjects with a higher urinary 2-OHE/16-OHE ratio were less likely to be diagnosed with breast cancer, but only when urine samples were collected prior to breast cancer treatment (ORTertile3(T3)versusTertile1(T1)=0.5, 95% CI (0.2, 1.1)). In contrast, a higher 2-OHE/16-OHE ratio was significantly associated with breast cancer among subjects providing urine specimens after treatment initiation (ORT3versusT1=8.7, 95% CI (1.6, 47.1)). This observed cross-over modification occurred within both pre-menopausal and post-menopausal women, and independent of body mass index or recent dietary intake. Conclusion: Cross-study differences in urine collection protocols may explain observed inconsistencies in the 2-OHE/16-OHE and breast cancer association. Our case-control analysis using pre-treatment urine samples suggested that a lower 2-OHE/16-OHE ratio was associated with an increased risk of pre-menopausal and post-menopausal breast cancer diagnosis among Chinese women.

Original languageEnglish (US)
Pages (from-to)65-72
Number of pages8
JournalSteroids
Volume68
Issue number1
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

Fingerprint

Metabolites
Estrogens
Breast Neoplasms
Urine
Oncology
Surgery
Urine Specimen Collection
Therapeutics
Estrogen Receptor beta
Registries
Metabolism
Logistics
Tumors
Immunoenzyme Techniques
Enzymes
Population
Case-Control Studies
China
Carcinogenesis
Breast

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Molecular Biology
  • Endocrinology
  • Pharmacology
  • Clinical Biochemistry
  • Organic Chemistry

Cite this

Urinary estrogen metabolites and breast cancer : Differential pattern of risk found with pre- versus post-treatment collection. / Fowke, Jay; Qi, Dai; Bradlow, H. Leon; Shu, Xiao Ou; Gao, Yu Tang; Cheng, Jin Rong; Jin, Fan; Zheng, Wei.

In: Steroids, Vol. 68, No. 1, 01.01.2003, p. 65-72.

Research output: Contribution to journalArticle

Fowke, Jay ; Qi, Dai ; Bradlow, H. Leon ; Shu, Xiao Ou ; Gao, Yu Tang ; Cheng, Jin Rong ; Jin, Fan ; Zheng, Wei. / Urinary estrogen metabolites and breast cancer : Differential pattern of risk found with pre- versus post-treatment collection. In: Steroids. 2003 ; Vol. 68, No. 1. pp. 65-72.
@article{e1ff89a3eb424003a23ef7d9dfc712c6,
title = "Urinary estrogen metabolites and breast cancer: Differential pattern of risk found with pre- versus post-treatment collection",
abstract = "Introduction: The products of estrogen metabolism may affect breast carcinogenesis. The 16α-hydroxyestrone (16-OHE) metabolite has a higher affinity for the estrogen receptor (ER) than the 2-hydroxyestrone (2-OHE) metabolite, while conjugated 2-OHE metabolite may inhibit angiogenesis. We investigated the association between the relative concentrations of these metabolites in urine (2-OHE/16-OHE) and breast cancer in a case-control study of Chinese women living in Shanghai. Methods: Incident breast cancer cases between 25 and 65 years of age (n=110) were identified from hospital or population tumor registries in Shanghai, China. Controls (n=110) were randomly selected from a complete registry of the Shanghai population, and individually matched to cases by menopausal status, age, and pre-treatment or post-treatment urine collection time. Urine samples were collected prior to any breast cancer treatment or surgery among 78 case-control pairs, while urine was collected after surgery, and perhaps other treatments, among 32 case-control pairs. A commercial enzyme-immunoassay kit was used to measure urinary estrogen metabolite concentrations. Conditional logistic regression was used to calculate odds ratios summarizing the 2-OHE/16-OHE and breast cancer association within subjects providing either pre-treatment or post-treatment urine samples. Results: Subjects with a higher urinary 2-OHE/16-OHE ratio were less likely to be diagnosed with breast cancer, but only when urine samples were collected prior to breast cancer treatment (ORTertile3(T3)versusTertile1(T1)=0.5, 95{\%} CI (0.2, 1.1)). In contrast, a higher 2-OHE/16-OHE ratio was significantly associated with breast cancer among subjects providing urine specimens after treatment initiation (ORT3versusT1=8.7, 95{\%} CI (1.6, 47.1)). This observed cross-over modification occurred within both pre-menopausal and post-menopausal women, and independent of body mass index or recent dietary intake. Conclusion: Cross-study differences in urine collection protocols may explain observed inconsistencies in the 2-OHE/16-OHE and breast cancer association. Our case-control analysis using pre-treatment urine samples suggested that a lower 2-OHE/16-OHE ratio was associated with an increased risk of pre-menopausal and post-menopausal breast cancer diagnosis among Chinese women.",
author = "Jay Fowke and Dai Qi and Bradlow, {H. Leon} and Shu, {Xiao Ou} and Gao, {Yu Tang} and Cheng, {Jin Rong} and Fan Jin and Wei Zheng",
year = "2003",
month = "1",
day = "1",
doi = "10.1016/S0039-128X(02)00116-2",
language = "English (US)",
volume = "68",
pages = "65--72",
journal = "Steroids",
issn = "0039-128X",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Urinary estrogen metabolites and breast cancer

T2 - Differential pattern of risk found with pre- versus post-treatment collection

AU - Fowke, Jay

AU - Qi, Dai

AU - Bradlow, H. Leon

AU - Shu, Xiao Ou

AU - Gao, Yu Tang

AU - Cheng, Jin Rong

AU - Jin, Fan

AU - Zheng, Wei

PY - 2003/1/1

Y1 - 2003/1/1

N2 - Introduction: The products of estrogen metabolism may affect breast carcinogenesis. The 16α-hydroxyestrone (16-OHE) metabolite has a higher affinity for the estrogen receptor (ER) than the 2-hydroxyestrone (2-OHE) metabolite, while conjugated 2-OHE metabolite may inhibit angiogenesis. We investigated the association between the relative concentrations of these metabolites in urine (2-OHE/16-OHE) and breast cancer in a case-control study of Chinese women living in Shanghai. Methods: Incident breast cancer cases between 25 and 65 years of age (n=110) were identified from hospital or population tumor registries in Shanghai, China. Controls (n=110) were randomly selected from a complete registry of the Shanghai population, and individually matched to cases by menopausal status, age, and pre-treatment or post-treatment urine collection time. Urine samples were collected prior to any breast cancer treatment or surgery among 78 case-control pairs, while urine was collected after surgery, and perhaps other treatments, among 32 case-control pairs. A commercial enzyme-immunoassay kit was used to measure urinary estrogen metabolite concentrations. Conditional logistic regression was used to calculate odds ratios summarizing the 2-OHE/16-OHE and breast cancer association within subjects providing either pre-treatment or post-treatment urine samples. Results: Subjects with a higher urinary 2-OHE/16-OHE ratio were less likely to be diagnosed with breast cancer, but only when urine samples were collected prior to breast cancer treatment (ORTertile3(T3)versusTertile1(T1)=0.5, 95% CI (0.2, 1.1)). In contrast, a higher 2-OHE/16-OHE ratio was significantly associated with breast cancer among subjects providing urine specimens after treatment initiation (ORT3versusT1=8.7, 95% CI (1.6, 47.1)). This observed cross-over modification occurred within both pre-menopausal and post-menopausal women, and independent of body mass index or recent dietary intake. Conclusion: Cross-study differences in urine collection protocols may explain observed inconsistencies in the 2-OHE/16-OHE and breast cancer association. Our case-control analysis using pre-treatment urine samples suggested that a lower 2-OHE/16-OHE ratio was associated with an increased risk of pre-menopausal and post-menopausal breast cancer diagnosis among Chinese women.

AB - Introduction: The products of estrogen metabolism may affect breast carcinogenesis. The 16α-hydroxyestrone (16-OHE) metabolite has a higher affinity for the estrogen receptor (ER) than the 2-hydroxyestrone (2-OHE) metabolite, while conjugated 2-OHE metabolite may inhibit angiogenesis. We investigated the association between the relative concentrations of these metabolites in urine (2-OHE/16-OHE) and breast cancer in a case-control study of Chinese women living in Shanghai. Methods: Incident breast cancer cases between 25 and 65 years of age (n=110) were identified from hospital or population tumor registries in Shanghai, China. Controls (n=110) were randomly selected from a complete registry of the Shanghai population, and individually matched to cases by menopausal status, age, and pre-treatment or post-treatment urine collection time. Urine samples were collected prior to any breast cancer treatment or surgery among 78 case-control pairs, while urine was collected after surgery, and perhaps other treatments, among 32 case-control pairs. A commercial enzyme-immunoassay kit was used to measure urinary estrogen metabolite concentrations. Conditional logistic regression was used to calculate odds ratios summarizing the 2-OHE/16-OHE and breast cancer association within subjects providing either pre-treatment or post-treatment urine samples. Results: Subjects with a higher urinary 2-OHE/16-OHE ratio were less likely to be diagnosed with breast cancer, but only when urine samples were collected prior to breast cancer treatment (ORTertile3(T3)versusTertile1(T1)=0.5, 95% CI (0.2, 1.1)). In contrast, a higher 2-OHE/16-OHE ratio was significantly associated with breast cancer among subjects providing urine specimens after treatment initiation (ORT3versusT1=8.7, 95% CI (1.6, 47.1)). This observed cross-over modification occurred within both pre-menopausal and post-menopausal women, and independent of body mass index or recent dietary intake. Conclusion: Cross-study differences in urine collection protocols may explain observed inconsistencies in the 2-OHE/16-OHE and breast cancer association. Our case-control analysis using pre-treatment urine samples suggested that a lower 2-OHE/16-OHE ratio was associated with an increased risk of pre-menopausal and post-menopausal breast cancer diagnosis among Chinese women.

UR - http://www.scopus.com/inward/record.url?scp=0037211257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037211257&partnerID=8YFLogxK

U2 - 10.1016/S0039-128X(02)00116-2

DO - 10.1016/S0039-128X(02)00116-2

M3 - Article

C2 - 12475724

AN - SCOPUS:0037211257

VL - 68

SP - 65

EP - 72

JO - Steroids

JF - Steroids

SN - 0039-128X

IS - 1

ER -