Androgen imbalance in premenopausal women with benign breast disease and breast cancer

Objective: The alteration of steroid hormonal status in premenopausal breas t disease (benign and malignant) were investigated by comparing the urinary profile of androgens and corticoids. Methods: The urinary concentrations of 25 androgens and corticoids were qua ntitatively determined by a gas chromatography-mass spectrometry system in patients with benign breast disease (35 cases, 20-54 years), breast cancer (34, 27-54), and healthy controls of similar age (25, 22-51). Results: In premenopausal patients with breast cancer, a significantly lowe r rate of excretion of 11-deoxy-17-ketosteroids and their metabolites was f ound in comparison with normal females. These levels were also inversely as sociated with benign breast disease. No significant differences were found between the three groups for the concentration of 11-oxy-17-ketosteroids, 1 7-hydroxy-corticoids and their metabolites. The urinary ratio of adrenal an drogen metabolites to cortisol metabolites [(11-DOKS & M)/11-OKS] declined in the order of normal female control (4.04 +/- 0.72; mean +/- SD), breast benign mass (2.29 +/- 0.42) and breast cancer (0.94 +/- 0.27). Conclusion: Our data suggest that the hormonal imbalance of androgen defici ency and/or corticoid sufficiency is closely associated with the benign and malignant conditions of premenopausal breast disease and the ratio of (11- DOKS & M)/11-OKS may be an effective discriminant factor of these groups. C opyright (C) 1999 The Canadian Society of Clinical Chemists.