Schernhammer Eva S, Sperati Francesca, Razavi Pedram, Agnoli Claudia, Sieri Sabina, Berrino Franco, Krogh Vittorio, Abbagnato Carlo, Grioni Sara, Blandino Giovanni, Schunemann Holger J, Muti Paola
Breast Cancer Res. 2013 Jun 18;15(3):R46. doi: 10.1186/bcr3438.
Previous studies showed that higher testosterone levels are associated with greater risk of breast cancer in premenopausal women, but the literature is scant and inconsistent.
In a prospective nested case-control study of 104 premenopausal women with incident breast cancer and 225 matched controls, all characterized by regular menstrual cycles throughout their lifetime, we measured the concentration of estradiol, total and free testosterone (FT), progesterone, sex hormone-binding globulin (SHBG), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in blood samples collected on days 20 through 24 of their cycles.
In logistic regression models, the multivariate odds ratios (ORs) of invasive breast cancer for women in the highest tertile of circulating FT compared with the lowest was 2.43 (95% confidence interval (95% CI), 1.15 to 5.10; Ptrend = 0.03), whereas for total testosterone, the association had the same direction but was not statistically significant (OR, 1.27; 95% CI, 0.62 to 2.61; Ptrend = 0.51). Endogenous progesterone was not statistically associated with breast cancer (OR, 1.16; 95% CI, 0.60 to 2.27; Ptrend = 0.75), nor were the other considered hormones.
Consistent with previous prospective studies in premenopausal women and our own earlier investigation, we observed that higher levels of FT are positively associated with breast cancer risk in women with regular menstrual cycles throughout their lifetimes. No evidence of risk was found associated with the other endogenous sex steroids.
既往研究表明，绝经前女性体内较高的睾酮水平与患乳腺癌的风险增加相关，但相关文献较少且不一致。
在一项针对104例患有新发乳腺癌的绝经前女性和225例匹配对照的前瞻性巢式病例对照研究中，所有研究对象一生的月经周期均规律，我们在她们月经周期的第20至24天采集血样，测定雌二醇、总睾酮和游离睾酮（FT）、孕酮、性激素结合球蛋白（SHBG）、促卵泡生成素（FSH）和促黄体生成素（LH）的浓度。
在逻辑回归模型中，循环FT处于最高三分位数的女性与最低三分位数的女性相比，浸润性乳腺癌的多变量优势比（OR）为2.43（95%置信区间（95%CI），1.15至5.10；P趋势=0.03），而对于总睾酮，其关联方向相同但无统计学意义（OR，1.27；95%CI，0.62至2.61；P趋势=0.51）。内源性孕酮与乳腺癌无统计学关联（OR，1.16；95%CI，0.60至2.27；P趋势=0.75），其他所考虑的激素也无关联。
与既往针对绝经前女性的前瞻性研究以及我们自己早期的调查一致，我们观察到，一生月经周期规律的女性中，较高水平的FT与乳腺癌风险呈正相关。未发现其他内源性性类固醇与风险相关的证据。
