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

Objective: The alteration of steroid hormonal status in premenopausal breast 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 quantitatively 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 lower rate of excretion of 11- deoxy-17-ketosteroids and their metabolites was found in comparison with normal females. These levels were also inversely associated with benign breast disease. No significant differences were found between the three groups for the concentration of 11-oxy-17-ketosteroids, 17-hydroxy-corticoids and their metabolites. The urinary ratio of adrenal androgen metabolites to cortisol metabolites [(11-DOKS and 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 deficiency and/or corticoid sufficiency is closely associated with the benign and malignant conditions of premenopausal breast disease and the ratio of (11-DOKS and M)/11-OKS may be an effective discriminant factor of these groups.