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Estrogen metabolite ratio: Is the 2-hydroxyestrone to 16α-hydroxyestrone ratio predictive for breast cancer?
MedLine Citation:
PMID:  21339936     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Experimental studies have shown that two main estrogen metabolites hydroxylated by CYP1A1 and CYP1B1 in the breast differentially affect breast cell proliferation and carcinogenesis. Although 16α-hydroxyestrone (16αOHE1) exerts estrogenic activity through covalent estrogen receptor (ER) binding, 2-hydroxyestrone (2OHE1) presumably has antiestrogenic capabilities. The ratio of 2OHE1 to 16αOHE1 represents the relative dominance of one pathway over the other and is believed to be modifiable by diet. It was hypothesized that women with or at high risk of breast cancer have a lower estrogen metabolite ratio (EMR) compared with women without breast cancer. We conducted a systematic review on the EMR as a predictor for breast cancer. A total of nine studies (six prospective and three retrospective) matched our inclusion criteria, comprising 682 premenopausal cases (1027 controls) and 1189 postmenopausal cases (1888 controls). For the highest compared with the lowest quantile of urinary EMR, nonsignificant associations suggested at best a weak protective effect in premenopausal but not in postmenopausal breast cancer (range of odds ratios: 0.50-0.75 for premenopausal and 0.71-1.31 for postmenopausal). Circulating serum/plasma EMR was not associated with breast cancer risk. Associations were inconclusive for receptor subtypes of breast cancer. Uncontrolled factors known to be involved in breast carcinogenesis, such as 4-hydroxyestrone (4OHE1) concentration, may have confounded results for EMR. Results of the prospective studies do not support the hypothesis that EMR can be used as a predictive marker for breast cancer risk. Future research should concentrate on profiles of estrogen metabolites, including 4OHE1, to gain a more complete picture of the relative importance of single metabolites for breast cancer.
Nadia Obi; Alina Vrieling; Judith Heinz; Jenny Chang-Claude
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Publication Detail:
Type:  Journal Article     Date:  2011-02-08
Journal Detail:
Title:  International journal of women's health     Volume:  3     ISSN:  1179-1411     ISO Abbreviation:  Int J Womens Health     Publication Date:  2011  
Date Detail:
Created Date:  2011-02-22     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101531698     Medline TA:  Int J Womens Health     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  37-51     Citation Subset:  -    
University Cancer Center Hamburg (UCCH)/Hubertus Wald Tumor Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
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