1. SERUM LEVELS OF SEX STEROIDS IN CARCINOMA BREAST OF LIBYAN WOMEN
A.M. Jarari2, J.R. Peela1, S. Shakila1, A.R. Said1, L.T. Peela6, R. Shembesh3, S.O. Alsoaeiti5, E.A. Hayam 2, M.J. Kadeer2, N.M.Jarari4
1.Department of Biochemistry, Faculty of Medicine, Quest International University Perak, Ipoh, Malaysia
2.Department of Biochemistry, Faculty of Medicine, University of Benghazi, Benghazi, Libya
3.Department of Oncology, Benghazi Medical Center, Benghazi, Libya
4.Department of Pharmacology, Faculty of Medicine, University of Benghazi, Benghazi, Libya
5.Department of Surgery, 7th October Hospital, Faculty of Medicine, University of Benghazi, Benghazi, Libya
6.Great Eastern Medical School, Srikakulam, India
Introduction
Results
Conclusion
Benign and malignant breast disorders are very common in Libyan women like other Arab countries particularly younger individuals than their counterparts in western world. An increase in the incidence of cancers has been reported in the Arab countries [1]. This could be attributed to various factors such as the robust epidemiological control of infectious diseases, increase in the average life span of the general population, higher socio-economic status, smoking, higher incidence of hepatitis B and C, and food fads. Breast cancer is one of the leading cancers, causing higher rate of morbidity and mortality comparable to that of other developed countries, however, with an earlier age of onset [2].
26% of all cancers are breast cancers in Libyan women as per the Benghazi cancer registry. [3]. Almost a decade ago, Singh and Al-Sudani [4] demonstrated that breast cancer is one of the top ten cancers responsible for higher mortality in Libya. In another study conducted between 1981 and 1985 [5], breast cancer was the most frequent tumor (29.8%) in females and the majority of these patients were of a younger age group (72.3% below 50 years). Almost all the patients selected for our study were multiparous and were exposed to breast-feeding [6]. A recent literature review by Najjar and Easson [6] provided evidence that the average age of onset of breast cancer in Arab women is 48 years and is almost a decade earlier than their western counterparts and this warrants effective screening and management strategies [7]. The present study is to compare the serum levels of sex hormones in benign and malignant disorders of breast.
Oestrogen were significantly elevated in carcinoma breast (p=0.001) when compared with controls. Oestrogen levels in patients with benign disorders were not significantly raised when compared with controls. There is significant difference between carcinoma breast (p=0.032) and fibroadenosis in Oestrogen levels. Serum progesterone levels were not significantly raised in both malignant (p=0.518) and benign disorders (p=0.564) when compared with controls. Same trend between benign and malignant disorders (p=0.680). Serum testosterone levels were also not high in carcinoma breast (p=0.3144) when compared with controls. The same trend followed between benign breast disorders 0p=0.077) when compared with controls and malignant disorders (p= 0.157). All results were summarised in table.1.
This study has shown a significant association between sex hormone, oestrogen and breast cancer risk. Further evaluation is required with a bigger sample size to decide on the impact of treatment based on the oestrogen levels.
References
Anim JT (1990) Breast cancer in Arab women: A review. Emirates Med J 8:
Elattar I (2005) Cancer in the Arab World: Magnitude of the Problem. UICC March
El Mistiri M, Verdecchia A, Rashid I, El Sahli N, El Mangush M, et al. (2007) Cancer incidence in eastern Libya: the first report from the Benghazi Cancer Registry, Int J Cancer 120:
Singh R, Al-Sudani OE (2001) Cancer mortality in Benghazi, Libyan Arab Jamahiriya, East Mediterr Health J 7:
Akhtar SS, Abu Bakr MA, Dawi SA, Huq IU (1993) Cancer in Libya--a retrospective study ( ). Afr J Med Med Sci 22:
Najjar H, Easson A (2010) Age at diagnosis of breast cancer in Arab nations. Int J Surg 8:
Bielecka-Dąbrowa A, Hannam S, Rysz J, Banach M (2011) Malignancy- Associated Dyslipidemia. Open Cardiovasc Med J 5:
Verkasalo PK1, Thomas HV, Appleby PN, Davey GK, Key TJ. Circulating levels of sex hormones and their relation to risk factors for breast cancer: a cross-sectional study in 1092 pre- and postmenopausal women (United Kingdom). Cancer Causes Control Jan;12(1):47-59.
Hankinson SE. Endogenous hormones and risk of breast cancer in postmenopausal women. Breast Dis ;24:3-15.
Becker S1, Kaaks R. Exogenous and endogenous hormones, mammographic density and breast cancer risk: can mammographic density be considered an intermediate marker of risk? Recent Results Cancer Res. 2009;181:
Type
Estrogen
Progesterone
Testosterone
Carcinoma
Breast
No of cases 11
Mean
112.41
2.58
0.27
Std Deviation
69.99
8.57
0.17
Controls 9
31.52
4.49
0.28
41.05
6.49
0.18
Fibro
adenosis 8
95.14
2.61
0.45
Std. Deviation
79.00
4.32
0.23
Discussion
Material and Methods
Factors such as obesity and perhaps waist-hip ratio, physical activity and alcohol consumption, but probably not age at menarche and parity, may mediate their effects on breast cancer risk by changing circulating concentrations of sex hormones. [8] A strong positive association between breast cancer risk and circulating levels of both estrogens and androgens has now been well confirmed; women with hormone levels in the top 20% of the distribution (versus bottom 20% have a 2- to 3-fold higher risk of breast cancer. Accumulating data also indicate a significant positive association with prolactin levels, although additional confirmation is needed. In contrast, no important link has been found between circulating levels of IGF-I (and its binding protein, IGFBP-3) and breast cancer risk in postmenopausal women [9]. Circulating (blood) levels of androgens, estrogens, and prolactin appear to be associated more specifically to the risk of ER+ tumors [10].
Data on sex hormone status in 12 cases of confirmed carcinoma of breast patients in the age group ranging from 30 – 55 years of age have been retrieved from the department of surgery, 7th October Hospital, Benghazi, Libya
and compared with that of the 12 cases of age matched controls free from both malignant and benign disorders of breast in this study. Serum oestrogen, progesterone and testosterone levels were estimated by using appropriate kits
with Cobas E411 analyser. Statistical analysis was done using SPSS software using Mann-Whitney and Wilcoxon tests.