SERUM-LIPIDS AND APOLIPOPROTEINS IN WOMEN WITH BREAST MASSES

Background: Human mammary tissue metabolizes lipids from plasma, a pro cess affected by female gonadal hormones. Both benign and malignant pr oliferation of breast tissue in women have been associated with change s in plasma lipid and lipoprotein levels. Methods: One hundred consecu tive women with breast masses (50 malignant, 50 benign) had diagnostic biopsies followed by axillary node dissection in those with cancer. F asting serum samples were taken just prior to biopsy and analyzed for lipid fatty acid and lipoprotein levels. Malignant breast tissue was a nalyzed for hormone receptor binding. Results. Low-density lipoprotein (LDL) components (total cholesterol, LDL-cholesterol, apolipoprotein B) were increased, but not significantly, in cancer patients compared to those with benign masses. Decreased levels of LDL-associated compon ents were found in women with cancer recurrence by 3 years. Three apol ipoproteins of high-density lipoprotein (apolipoprotein A-I, apolipopr otein A-II, apolipoprotein D) were more affected by the presence of br east masses than the lipids were. Fibrocystic disease, type of hormone binding, and recurrence within 3 years were significantly related to apolipoprotein changes, especially apolipoprotein D levels with hormon e receptor binding and the apolipoprotein A-I/apolipoprotein B ratio w ith breast cancer recurrence. Conclusions: Prior to diagnostic biopsy, serum lipid and apolipoprotein components of low-density lipoproteins were increased in women with fibrocystic disease and early stage canc er but decreased in women with early recurrence. However, apolipoprote in A-I, apolipoprotein A-II, and apolipoprotein D, of the high-density lipoproteins, were more affected than serum lipids. The ratio of apol ipoprotein A-I to apolipoprotein B serum levels at time of biopsy was the best predictor of cancer recurrence.