URINARY TESTOSTERONE AS A MARKER OF RISK OF RECURRENCE IN OPERABLE BREAST-CANCER

We investigated the role of urinary testosterone levels as a marker of risk of recurrent disease in 113 operable breast cancer patients (70 premenopausal, 43 postmenopausal). Twenty-four-hour urine collections for testosterone measurement were obtained before surgical treatment, between 20-40 days thereafter, and then every 6 months for 5 years. Th e cutoff values to separate 'high testosterone (A+)' from 'normal test osterone (A-)' were 8.0 mug/24 h in premenopause and 4.9 mug/24 h in p ostmenopause. Urinary testosterone levels were considered high when th ey exceeded the cutoff value in at least 2 of the first 3 measurements (pretreatment, post-treatment, 6 months) of each patient. According t o the aforementioned criterion, 33 patients (29.2%) had high testoster one levels, which were associated to axillary node involvement in 16 p atients. Thirteen of the latter relapsed during the 5-year follow-up p eriod (5/7 in premenopause, 8/9 in postmenopause). Relapse-free surviv al (RFS) curves were drawn only for node-positive patients owning to t he small number of recurrences observed in the node-negative group. In premenopausal node-positive patients, RFS was significantly different for patients presenting high and normal urinary testosterone levels ( 77% vs 28%, respectively; logrank test, p < 0.006). In postmenopausal node-positive patients, RFS was also different between the two groups (54% vs 11% in 'high' and 'normal' excretors, respectively) but the di fference was not statistically significant. The present findings sugge st that urinary testosterone is a prognostic indicator of early breast cancer recurrence in node-positive patients.