To assess whether risk of breast cancer in young women is associated with differences in luteal-phase hormone production and to attempt to explain differences in risk of breast cancer of young Shanghai Chinese and Los Angeles white women, two concurrent case-control studies of serum hormone concentrations were conducted. Both studies were carefully controlled for the possible confounding effects of age, weight, height, pregnancy history, and day of the menstrual cycle, by individually matching cases and controls on these factors. Case eligibility was limited to women with localized breast cancer. Sixteen of 39 Shanghai breast-cancer cases were sampled prior to the histologic diagnosis of their disease. The remaining 23 Shanghai cases and all 42 Los Angeles cases were diagnosed, and treated by surgery only, at least six months prior to hormonal evaluation. All subjects were sampled on day 22 of the menstrual cycle. Overall, cases had 13.5% higher serum estradiol concentrations (p=0.038) with a case-to-control excess of 16.6% in Shanghai subjects (p=0.089) and 10.8% in Los Angeles subjects (p=0.23). There were no appreciable differences in amounts of sex-hormone binding globulin between cases and controls. Cases had lower progesterone levels than controls, but the situation was reversed when the analysis was restricted to subjects with evidence of ovulation. Los Angeles controls had 20.6% greater estradiol concentrations than Shanghai controls (p=0.036); adjustment for body weight accounted for only 25.7% of this difference. This higher level of estradiol in Los Angeles women could be an important part of the explanation of the two-to-three-fold differences in breast cancer incidence rates of women under age 45 in Shanghai and Los Angeles.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Pike MC, Krailo MD, Henderson BE, Casagrande JT, Hoel DG. Hormonal' risk factors, ‘breast tissue age’ and the age-incidence of breast cancer. Nature 1983; 303: 767–70.
Henderson BE, Ross RK, Judd HL, Krailo MD, Pike MC. Do regular ovulatory cycles increase breast cancer risk? Cancer 1985; 56: 1206–8.
Kelsey JL. A review of the epidemiology of human breast cancer. Epidemiol Rev 1979; 1: 74–109.
Henderson BE, Pike MC, Casagrande JT. Breast cancer and the oestrogen window hypothesis. Lancet 1971; ii: 363–4.
Olsson H, Landin-Olsson M, Gullberg B. Restrospective assessment of menstrual cycle length in patients with breast cancer, in patients with benign breast disease, and in women without breast disease. JNCI 1983; 70: 17–20.
MacMahon B, Trichopoulos D, Brown J, et al. Age at menarche, probability of ovulation and breast cancer risk. Int J Cancer 1982; 29: 13–16.
Apter D, Vihko R. Early menarche, a risk factor for breast cancer, indicates early onset of ovulatory cycles. J Clin Endocrinol Metab 1983; 57: 82–6.
Dao TL. The role of ovarian steroid hormones in mammary carcinogenesis. In: Pike MC, Siiteri PK, Welsch CW eds Hormones and Breast Cancer: Banbury Report 8, New York. Cold Spring Harbor Laboratory, Cold Spring Harbor, 1981: 281–95.
Anderson TJ, Ferguson DJP, Raab GM. Cell turnover in the ‘resting’ human breast: influence of parity, contraceptive pill, age and laterality. Br J Cancer 1982; 46: 376–82.
Longacre TA, Bartow SA. A correlative morphologic study of human breast and endometrium in the menstrual cycle. Am J Surg Pathol 1986: 10: 382–93.
Muir C, Waterhouse J, Mack T, Powell J, Whelan S. Cancer Incidence in Five Continents. Vol V, IARC Scientific Publication No. 88, Lyon: International Agency for Research on Cancer, 1987.
Yuan JM, Yu MC, Ross RK, Gao YT, Henderson BE. Risk factors for breast cancer in Chinese women in Shanghai. Cancer Res 1988; 48: 1949–53.
Bernstein L, Pike MC, Krailo M, Henderson BE. Update of the Los Angeles study of oral contraceptives and breast cancer: 1981 and 1983. In: Mann RD, ed. Oral Contraceptives and Breast Cancer, Park Ridge, NJ: Parthenon Publishing Group, 1989: 169–81.
Hayward JL, Greenwood FC, Glober G, et al. Endocrine status in normal British, Japanese and Hawaiian-Japanese women. Europ J Cancer 1978; 14: 1221–8.
Goldin BR, Adlercreutz H, Gorbach SL et al. The relationship between estrogen levels and diets of Causasian American and Oriental immigrant women. Am J Clin Nutr 1986; 44: 945–53.
Gray GE, Pike MC, Hirayama T, et al. Diet and hormone profiles in teenage girls in four countries at different risk for breast cancer. Prev Med 1982; 11: 108–13.
England PC, Skinner LG, Cottrell KM, Sellwood RA. Serum oestradiol-17b in women with benign and malignant breast disease. Br J Cancer 1974; 30: 571–6.
Malarkey WB, Schroeder LL, Stevens VC, James AG, Lanese RR. Twenty-four-hour preoperative endocrine profiles in women with benign and malignant breast disease. Cancer Res 1977; 37: 4655–9.
Drafta D, Schindler AF, Milcu M, et al. Plasma hormones in pre- and post-menopausal breast cancer. J Steroid Biochem 1980; 13: 793–802.
Bruning PF, Bronfrer JMG, Hart AAM. Non-protein bound oestradiol, sex hormone binding globulin, breast cancer and breast cancer risk. Br J Cancer 1985; 51: 479–84.
Myer F, Brown JB, Morrison AS, MacMahon B. Endogenous sex hormones, prolactin, and breast cancer in premenopausal women. JNCI 1986; 77: 613–16.
Key TJA, Pike MC. The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer. Eur J Cancer Clin Oncol 1988; 24: 29–43.
Westphal U. Steroid-protein Interactions—II. Monographs on Endocrinology. Berlin: Springer-Verlag, 1986.
Mack TM. Cancer surveillance program in Los Angeles County. Natl Cancer Inst Monogr 1977; 48: 99–101.
Pike MC, Henderson BE, Krailo MD, Duke A, Roy S. Breast cancer in young women and use of oral contraceptives: possible modifying effect of formulation and age at use. Lancet 1983; ii: 926–30.
Stanczyk FZ, Shoupe D, Nunez V, Macial-Gonzales P, Vijod M, Lobo RA. A randomized comparison of normal estradiol delivery in post-menopausal women. Am J Obstet Gynecol 1988; 159: 1540–6.
Scott JZ, Stanzyk FZ, Goebelsmann V, Mishell DR. A double-antibody radioimmunoassay for serum progesterone using progesterone-3-(0-carboxymethyl) oximino-[125I]-iodohistamine as radioligand. Steroids 1978; 31: 393–405.
Stumpf PG, Nakamura RM, Mishell DR. Changes in physiologically free circulating estradiol and testosterone during exposure to levonorgestrel. J Clin Endocrinol Metab 1981; 52: 138–43.
Israel R, Mishell DR, Stone SC, Thorneycroft IH, Moyer DL. Single luteal phase serum progesterone assay as an indicator of ovulation. Am J Obstet Gynecol 1972; 112: 1043–6.
MacMahon B, Cole P, Brown JB, Paffenbarger R, Trichopoulos D, Yen S. Urine estrogens, frequency of ovulation, and breast cancer risk: case-control study in premenopausal women. JNCI 1982; 70: 247–50.
Moore JW, Clark GMG, Bulbrook RD, et al. Serum concentrations of total and non-protein-bound oestradiol in patients with breast cancer and in normal controls. Int J Cancer 1982; 29: 17–21.
Secreto G, Recchione C, Fariselli G, Di Pietro S. High testosterone and low progesterone circulating levels in premenopausal patients with hyperplasia and cancer of the breast. Cancer Res 1984; 44: 841–4.
Langley MS, Hammond GL, Bardsley A, Sellwood RA, Anderson DC. Serum steroid binding proteins and the bioavailability of estradiol in relation to breast disease. JNCI 1985; 75: 823–9.
Moore JW, Clark GMG, Hoare SA, et al. Binding of oestradiol to blood proteins and aetiology of breast cancer. Int J Cancer 1986; 38: 625–30.
Takatani O, Kosano H, Okumoto T, Adamatsu K, Tamakuma S, Hiraide H. Distribution of estradiol and percentage of free testosterone in sera of Japanese women: preoperative breast cancer patients and normal controls. JNCI 1987; 79: 1199–204.
Siiteri PK, Simberg N, Murai J. Estrogens and breast cancer. Ann NY Acad Sci 1986; 464: 100–5.
Ota DM, Jones LA, Jackson GL, Jackson PM, Kemp K, Bauman D. Obesity, non-protein-bound estradiol levels, and distribution of estradiol in the sera of breast cancer patients. Cancer 1986; 57: 558–62.
MacMahon B, Cole P, Brown JB, et al. Urine oestrogen profiles of Asian and North American women. Int J Cancer 1984; 14: 161–7.
Moore JW, Clark GMG, Takatani O, Wakabayashi Y, Hayward JL, Bulbrook RD. Distribution of 17b-estradiol in the sera of normal British and Japanese women. JNCI 1983; 71: 749–54.
Goodman MH, Bulbrook RD, Moore JW. The distribution of estradiol in the sera of normal Caucasian, Chinese, Filipina, Hawaiian and Japanese women living in Hawaii. Eur J Cancer Clin Oncol 1988; 24: 1855–60.
Additional information
Drs Bernstein, Ross, Pike and Henderson and Ms Hanisch are in the Department of Preventive Medicine, University of Southern California School of Medicine, 1420 San Pablo Street, PMB A-202, Los Angeles, CA 90033. Drs Yuan and Gao are with the Shanghai Cancer Institute, 2200 Xie Tu Road, Shanghai, People's Republic of China. Drs Lobo and Stanczyk are in the Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Women's Hospital, 1240 North Mission Road, Los Angeles, CA 90033. Reprint requests should be addressed to Dr Bernstein. This work was supported by grants CA17054 and CA33512 from the National Institutes of Health.
Rights and permissions
About this article
Cite this article
Bernstein, L., Yuan, JM., Ross, R.K. et al. Serum hormone levels in pre-menopausal Chinese women in Shanghai and white women in Los Angeles: results from two breast cancer case-control studies. Cancer Causes Control 1, 51–58 (1990). https://doi.org/10.1007/BF00053183
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00053183