What is the effect of androgens on a women's risk for breast cancer?

Updated: Dec 26, 2019
  • Author: Graham A Colditz, MD, DrPH; Chief Editor: Chandandeep Nagi, MD  more...
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Answer

Androgens have been hypothesized to increase breast cancer risk either directly, by increasing the growth and proliferation of breast cancer cells, or indirectly, by their conversion to estrogen. In postmenopausal women, the best summary of evidence on circulating androgens and breast cancer risk is from the pooled analysis of 9 prospective studies described above. [33] Testosterone was positively associated with breast cancer risk: the RRs (95% CI) for increasing quintile category (all relative to the lowest quintile of levels) were 1.3 (1.0-1.9), 1.6 (1.2-2.2), 1.6 (1.1-2.2), and 2.2 (1.6-3.1).

Findings were generally similar for other androgens with RRs of 2 or more comparing top versus bottom quintiles for androstenedione, dehydroepiandrosterone, and for dehydroepiandrosterone sulfate. When estradiol was added to the statistical models, RRs for the androgens were only modestly attenuated, suggesting an independent effect of circulating androgens on cancer risk.

Among premenopausal women, data on circulating androgens are more limited. No association was found between testosterone and breast cancer risk in two prospective studies, but a positive association for receptor-positive tumors was found in Nurses Health Study II. [35] Again, the data are too limited to draw any firm conclusions relating androgen levels to breast cancer risk in premenopausal women.


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