Sex Hormones, Oestrogen Receptor, Progesterone Receptor and Human Epithelial Receptor 2 Expressions in Pre and Postmenopausal Sub-Saharan African Women with Breast Cancer

Abstract

Aim: This study was carried out to determine the serum levels of sex hormones and gonadotropins as well as the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epithelial receptor 2 (HER 2) in pre and postmenopausal women with breast cancer. Study Design: Case-control study. Place and Duration of Study: Surgical Oncology Clinic, University College Hospital, Ibadan, Nigeria between April 2011 and July 2014. Methodology: 169 non-pregnant women aged 48.3±1.3 years were recruited for this study. They comprised of 85 histologically confirmed breast cancer pre-therapy (cases) matched with 84 apparently healthy women without breast cancer (controls) according to age and menstrual phase. Both cases and controls were subdivided into pre and postmenopausal groups (54 premenopausal cases; 31 postmenopausal cases; 53 premenopausal controls; 31 postmenopausal controls respectively). Anthropometry and reproductive history were obtained by standard methods. Blood (10ml) was obtained from participants and centrifuged to obtain serum. Oestradiol, progesterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined using enzyme immunoassay (EIA). Expression of ER, PR and HER 2 were determined by immunohistochemistry. Data analysed by Chi-square, Student’s t-test and multiple regression were considered statistically significant at p<0.05. Results: All premenopausal cases (100%) had ER and PR receptor negative expressions out of which 46(88.5%) had HER 2 receptor negative expression. Oestradiol and progesterone were significantly higher in postmenopausal cases compared with controls (p<0.05) while FSH and LH were significantly higher in premenopausal cases than controls (p<0.05). Conclusion: The pathophysiology of breast cancer may be based on menstrual phase. Elevated gonadotropins and sex hormones may be important in premenopausal and postmenopausal women with breast cancer. Triple negative breast cancer observed in 88.5% of premenopausal women with breast cancer is critical in the management of the disease especially in younger women.