Estrogen and progesterone hormone receptor status in pre-menopausal and postmenopausal women with invasive ductal carcinoma in a private tertiary hospital in Cebu City, Philippines: A retrospective study

OBJECTIVE@#This study was conducted to determine the difference of hormone receptor status between pre-menopausal and postmenopausal women diagnosed with invasive ductal carcinoma in the local setting. @*METHODS@#This retrospective descriptive study used data gathered from chart review of premenopausal and postmenopausal female patients diagnosed with invasive ductal carcinoma by tissue biopsy and underwent determination of hormone receptor status (estrogen and progesterone receptor) by immunohistochemical staining (ICA) using biopsy samples taken from June 2016 to December 2019 at Cebu Velez General Hospital, Cebu City. The significance of the difference in the hormone receptor status with menopausal status was analyzed using Fisher’s exact test.@*RESULTS@#Comparing the two groups, 25 (60%) of the pre-menopausal women and 37 (73%) of the post-menopausal women were determined as hormone sensitive, while 17 (40%) pre-menopausal women and 14 (27%) post-menopausal women were hormone resistant. The Fisher’s exact test did not detect a statistically significant difference in the hormone receptor status of pre-menopausal and post-menopausal breast cancer patients.@*CONCLUSION@#There is no significant difference on the hormonal receptor status among pre-menopausal and post-menopausal women diagnosed with invasive ductal carcinoma. Thus, the need for hormone receptor status determination in these patients should be emphasized to aid in proper diagnosis, prognostication, and treatment planning.

Comparison of efficiency between RMI1 and RMI2 in diagnosing ovarian malignancy

Background: This study was conducted in department of obstetrics and gynaecology, to know the efficiency of risk of malignancy index (RMI) to differentiate a malignant from a benign tumor and to compare the efficiency of risk of malignancy index 1 and 2 (RMI1 and RMI2). The study was conducted from June 2012 to August 2013 in women who got admitted with adnexal tumor.Methods: It was a prospective study. A proforma was designed for each patient which included, name, age, complaints, menopausal status, parity, past and family history and associated medical condition were asked. Indivisual parameters namely ultrasound score, CA125 and menopausal status and risk of malignancy index was calculated and compared with final histopathological diagnosis and sensitivity specificity and positive predictive value was calculated for each.Results: : The sensitivity of RMI1 is 87.95%, specificity is 75%, positive predictive value is 94.8%, negative predictive value is 54.54%, percentage of false negative is 12.04% and percentage of false positive is 25%. The sensitivity of RMI2 is 86.74%, specificity is 81.25%, positive predictive value is 96%, negative predictive value is 54.16%, percentage of false negative is 13.25% and percentage of false positive is 18.75%.Conclusions: The efficiency of RMI was definitely better than indivisual parameters and efficiency of RMI 1 and RMI2 are similar.

Association of metabolic syndrome with chronic kidney disease in premenopausal and postmenopausal women / 南方医科大学学报

OBJECTIVE@#To explore the relationship between metabolic syndrome (MS) and the risk for chronic kidney disease (CKD) in premenopausal and postmenopausal women.@*METHODS@#We conducted a cross-sectional study among 1346 community-based women from June to October 2012 and collected the data of personal history, lifestyle, physical measures and laboratory indicators. The diagnosis of CKD was established for an eGFR of less than 60 mL/min per 1.73 m or albuminuria. The diagnosis of metabolic syndrome was based on the International Diabetes Federation Guide. According to an epidemiological survey in Guangdong province, women older than 48.9 years were classified as having a postmenopausal status. The prevalence of MS and CKD was determined in both the premenopausal and postmenopausal women, and the association between MS and CKD was analyzed using logistic regression models.@*RESULTS@#MS was significantly correlated with CKD in premenopausal women in both unadjusted analyses (OR=3.10, 95% : 1.32-7.28, =0.009) and in analysis after adjustment for potential confounders (OR=4.09, 95% : 1.63- 10.32, =0.003). When adjusted for diabetes, hypertension, and hyperuricemia, no correlation was found between MS and CKD in premenopausal women (OR=1.56, 95% : 0.31-7.63, = 0.592); in the unadjusted analyses, MS was significantly correlated with CKD in postmenopausal women ( < 0.001). After further adjustment for age, education status, current smoking, physical inactivity, and current drinking, MS was still significantly correlated with CKD (OR=2.60, 95% : 1.69-3.99, < 0.001). When adjusted for diabetes, hypertension, and hyperuricemia, the correlation between MS and CKD was still significant (OR=1.61, 95% : 1.09-2.37, =0.018). In the unadjusted model, a high blood pressure (OR=2.77, 95%CI: 1.57-4.89, < 0.001), an elevated serum triglyceride level (OR=1.84, 95%: 1.16-2.90, =0.009) and a high fast glucose level (OR=2.07, 95%: 1.30-3.28, =0.002) were all significantly correlated with CKD in postmenopausal women. After adjusting for age, current smoking, current alcohol use, education status and physical inactivity, a high blood pressure (OR=2.28, 95%: 1.22-4.26, =0.01), a high serum triglyceride level (OR=1.71, 95%: 1.03-2.86, =0.039) and a high fast glucose (OR=2.25, 95%: 1.36-3.73, =0.002) were still significantly correlated with CKD in postmenopausal women. Blood pressure, serum triglyceride level, fast glucose, serum HDL cholesterol level and central obesity were not correlated with CKD in either the unadjusted model or adjusted model in premenopausal women ( > 0.05).@*CONCLUSIONS@#MS is correlated with CKD in both premenopausal and postmenopausal women, and the association is dependent on diabetes, hypertension, and hyperuricemia in premenopausal women but not in postmenopausal women.

Association of age at menarche with the risks of diabetes mellitus and metabolic syndrome in adulthood in Shanghai Jiading community postmenopausal women / 中华内分泌代谢杂志

Objective To investigate the association of age at menarche with the risks of diabetes and metabolic syndrome ( MS) in adulthood in Shanghai community postmenopausal women. Methods A total of 10375 residents over 40 years in Jiading, Shanghai were identified by a cluster sampling method. After taking standardized questionnaire surveys, physical examinations, and biochemical parameters testing, we gathered their lifestyle and medicine information. A total of 4723 postmenopausal women were enrolled in the study. The population was divided into three groups according to age at menarche, and their risks of MS and diabetes in various groups were compared. Results After multivariate adjustment, postmenopausal women with a menarche age<15 years had a 29％increased risk of diabetes(95％CI 1.03-1.61) and a 45％ increased risk of MS(95％ CI 1.20-1.76) in adulthood, compared with those with menarcheal age at 15-18 years. Among the five components of MS, earlier age of menarche was associated with higher risks of hypertriglyceridemia, low high density lipoprotein-cholesterol, and central obesity. Conclusions In Shanghai Jiading community postmenopausal women, age at menarche is associated with the risk of diabetes and MS, independent of the body mass index in adulthood.

Analysis of the effect of menopausal status and molecular subtype on survivals among breast cancer patients / 中华预防医学杂志

Objective@#To analyze the associations between molecular subtypes and overall breast cancer survival among premenopausal and postmenopausal breast cancer in Beijing, and to provide basic information for breast cancer clinical researches and control.@*Methods@#All the resident patients diagnosed with breast cancer in four well-established hospitals were retrieved from Beijing cancer registry, related information, such as TNM stages, receptor status, histological grade, height, weight, were collected by case extraction. Cancer registration information and population-based follow-up information were used to acquire survival outcome. All the patients were followed up until 31 December 2015, 4 531 cases with invasive, primary breast were included in the final analysis. All the cases were classified into Luminal and non-Luminal according to receptor status. Five-year survival rates of the two subtypes were estimated by the life-table method. Multivariable Cox proportional hazards models were employed to evaluate the associations between molecular subtypes and breast cancer survival.@*Results@#Of all the 4 531 patients, premenopausal patients accounted for 44.5% (2 017 cases) and postmenopausal patients accounted for 55.5% (2 514 cases). 643 cases died during the study period. Overall five-year survival was 89.5% (95%CI: 88.6%-90.4%), for premenopausal and postmenopausal patients, they were 92.1% (95%CI: 90.9%-93.3%), and 87.5% (95%CI: 86.2%-88.8%), respectively. Among all the patients, 3 730 patients had molecular subtype, 76.7% (2 861 cases) were Luminal breast cancer, and 23.3% (869 cases) were non-Luminal breast cancer. Five-year survival rates for Luminal and non-Luminal were 91.8% (95%CI: 90.8%-92.8%), and 83.2% (95%CI: 80.7%-85.7%), respectively. No matter in premenopausal or postmenopausal patients, non-Luminal breast cancer had significantly higher risk of death compared to Luminal breast cancer (premenopausal: HR=1.85, 95%CI: 1.26-2.73; premenopausal: HR=1.42, 95%CI: 1.07-1.88).@*Conclusion@#For both premenopausal and postmenopausal breast cancer patients, non-Luminal breast cancer had lower five-year survival rates than Luminal breast cancer, which was a risk factor on breast cancer survival.

Relationship between serum uric acid levels and metabolic syndrome in Chinese premenopausal women,postmenopausal women, and men / 中华内分泌代谢杂志

Objective The study was conducted to investigate the incidence of metabolic syndrome ( MS) and hyperuricemia in Chinese community residents, and to assess differences of menopausal status and genders in the relationship between MS and serum uric acid ( SUA ) levels. Methods A total of 10191 subjects ( 5838 postmenopausal women, 726 premenopausal women, and 3627 men) were recruited in this cross-sectional study. All participants received standard questionnaire survey, physical examination, oral glucose tolerance test, and laboratory examination ( serum uric acid, serum lipid, liver and kidney functions ) . MS was diagnosed according to the International Diabetes Federation ( IDF) criteria. Hyperuricemia was defined as SUA>420μmol/L for men and>360μmol/L for women. Results The prevalence of hyperuricemia was 14. 4％ in men, 11. 8％ in postmenopausal women, and 6. 2％ in premenopausal women. The prevalence of MS was 35. 2％ in men, 46. 2％ in postmenopausal women, and 28. 9％ in premenopausal women. The body mass index, waist circumference, and triglycerides levels were most strongly associated with SUA levels in all groups, while the correlation coefficients of these factors were higher in females than those in males. Individuals in the highest SUA quartile had 3. 538-fold, 2. 088-fold, and 1. 404-fold increased risk of MS as compared with those in the lowest quartile in premenopausal women, postmenopausal women, and men, respectively. The risks of developing each components of MS in females were higher than those in males. Conclusions There is an association between SUA level and MS, and the relationships between SUA levels and MS were much closer in females than those in males. Individuals with higher SUA levels were more likely to develop MS and its components than those with lower SUA levels. Premenopausal women with high level of SUA may have the highest risk of developing MS in Chinses community residents.

Evaluación de los niveles de lípidos y del estado de insulinorresistencia en pre- y postmenopáusicas / Evaluation of lipid levels and insulin resistance in pre- and postmenopausal women / Avaliação dos níveis de lipídios e do estado de resistência à insulina em pré- e pós-menopausa

El objetivo del trabajo consistió en evaluar la relación entre los niveles de lípidos y parámetros que definen el estado de insulinorresistencia con la edad, el estado menopáusico (EM) y el índice de masa corporal (IMC) en la pre- y postmenopausia. En este estudio de corte transversal se seleccionaron 89 mujeres: 42 premenopáusicas (Pre) y 47 postmenopáusicas (Post). Se midieron: FSH, LH, estradiol e insulina por MEIA, colesterol total (CT), triglicéridos (TG), colesterol de lipoproteínas de baja densidad (C-LDL), colesterol de lipoproteínas de alta densidad (C-HDL) y glucosa por métodos químicos convencionales. El colesterol de LDL pequeñas y densas (C-LDLpyd) se obtuvo por cálculo. Las pacientes Post mostraron niveles más elevados de CT (p<0,0001), C-LDL (p<0,0001), C-HDL (p=0,0283), TG (p=0,0014), C-LDLpyd (p=0,0001), CT/C-HDL (p=0,0016) y glucosa (p=0,0048) que las Pre. No se hallaron diferencias significativas en los valores de insulina ni del índice TG/C-HDL. El análisis de regresión múltiple mostró que los valores de CT, C-LDL y C-HDL se relacionaron lineal y positivamente con la edad. Los niveles de C-LDL medido, TG, CT/C-HDL, C-LDLpyd, glucosa, insulina y TG/C-HDL se asociaron positivamente con IMC. C-HDL se relacionó negativamente con IMC. Sólo el C-LDLpyd presentó linealidad positiva con el EM.

The purpose of this study was to evaluate the relationship between lipid levels and insulin resistance parameters with age, menopausal status (MS) and body mass index (BMI) in pre- and postmenopausal women. This cross-sectional study included 89 women: 42 premenopausal (Pre) and 47 postmenopausal (Post). FSH, LH, estradiol and insulin were measured by MEIA. Total-cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and glucose were measured by conventional clinical chemistry methods. Small and dense LDL-C (sdLDL-C) was estimated by calculation. Post women showed higher values of TC (p<0.0001), LDL-C (p<0.0001), HDL-C (p=0.0283), TG (p=0.0014), sdLDL-C (p=0.0001), TC/HDL-C ratio (p=0.0016) and glucose (p=0.0048) than Pre. Insuline and TG/HDL-C ratio were not different between groups. Multiple regression analysis showed TC, LDL-C and HDL-C levels to be linearly and positively associated to age. Measured LDL-C, TG, TC/HDL-C ratio, sdLDL-C, glucose, insulin and TG/HDL-C ratio showed linear and positive relationship with BMI. HDL-C was negatively associated to IMC. Only sdLDL-C concentrations were associated positively to MS.

O objetivo deste trabalho é avaliar a relação entre os níveis de lipídios e parâmetros que definem o estado de resistência à insulina com a idade, estado menopausal (EM) e índice de massa corporal (IMC) na pré- e pós-menopausa. Neste estudo de corte transversal, foram selecionadas 89 mulheres: 42 pré-menopausa (Pré) e 47 pós-menopausa (Pós). Foram medidos: FSH, LH, estradiol e insulina pelo MEIA. Colesterol total (CT), triglicerídeos (TG), colesterol de lipoproteínas de baixa densidade (C-LDL), colesterol de lipoproteínas de alta densidade (C-HDL) e glicose através de métodos químicos convencionais. O colesterol de LDL pequenas e densas (C-LDLpyd) foi obtido por cálculo. Pacientes Pós-menopausa apresentaram níveis mais altos de CT (p<0,0001), C-LDL (p<0,0001), C-HDL (p=0,0283), TG (p=0,0014), C-LDLpyd (p=0,0001), CT/C-HDL (p=0,0016) e glicose (p=0,0048) do que as Pré-menopausa. Não foram encontradas diferenças significativas nos valores de insulina nem do índice de TG/C-HDL. A análise de regressão múltipla mostrou que os valores de CT, C-LDL e C-HDL foram linear e positivamente relacionados com a idade. Os níveis de C-LDL medido, TG, CT/C-HDL, C-LDLpyd, glicose, insulina e TG/C-HDL foram associados positivamente com IMC. C-HDL se relacionou negativamente com IMC. Apenas o C-LDLpyd apresentou linearidade positiva com o EM.

Clinicopathological characteristics of patients of certain molecular subtypes and elevated postoperative cancer antigen 15.3 levels and its correlation with menopausal status.

Context: It is well established that breast cancer subtypes differ in their outcome and treatment response. Aim: To observe tumor characteristics of different molecular subgroup and patients with postoperative (PO) raised cancer antigen 15.3 (CA 15.3) group and variation of tumor nature between pre‑ and post‑menopausal breast cancer patients. Materials and Methods: Blood samples and tumor blocks were collected from 95 nonmetastatic female breast cancer patients. Immunohistochemical stains for estrogen receptors (ER), progesterone receptor (PR), and HER2/Neu were used to classify molecular subtypes. CA 15.3 level was detected by ELISA. Significance levels were ascertained by Pearson Chi‑square test. Results: Prevalence of luminal A tumor with grade 3 was high. Triple negative and ER positive (ER+) types showed tumors with high grade and high lymph node (LN) metastasis. More nodal involvement was noticed in patients with PO raised CA 15.3. In addition, premenopausal patients with triple‑negative and ER+ subtypes exhibited more aggressive tumors which were characterized by high grade and large numbers of LN metastasis. Conclusion: Clinicopathological characteristics of certain molecular subtypes and influence of menopausal status on it can predict disease recurrence or overall survival of breast cancer patients.

The Timing of Recurrence Dependent on Menopausal Status after Surgery for Breast Cancer

PURPOSE: This study was aimed at evaluating the timing of clinical recurrence after surgical removal of the primary tumor. METHODS: The hazard rate for recurrence during the first 5 years after surgery was studied in 1,225 female patients from 1995 to 2003 at Kyungpook National University Hospital. Subset analyses were performed according to menopausal status and axillary lymph node involvement. RESULTS: The group of premenopausal women has one peak hazard rate in the 18~24 month period after surgery, while that of postmenopausal women has two peaks at 18~24 months and 42~48 months. The hazard rate of node positive group is much higher than node negative group at all periods. In the premenopausal group, patients with less than 3 node metastases have a peak hazard rate at about 18~24 months, while those with more than 4 lymph node metastases have that in 6~12 months. In the postmenopausal group, patients with less than 3 node metastases have the peak hazard rate at 18~24 months, while more than 4 lymph node metastases have two peaks at 18~24 months and 42~48 months. CONCLUSION: Both premenopausal and postmenopausal groups similarly show the peaked hazard rate of recurrence at about 2 years after surgery. In premonopausal young women, the status of nodal metastasis affects early recurrence, while in postmenopausal women, more nodal metastasis related with late recurrence at about 45 months. Menopausal status according to axillary node involvement shows the different recurrence pattern.

PvuII polymorphism of estrogen receptor-α gene in breast cancer.

BACKGROUND: Estrogen receptor (ER) is a ligand-inducible transcription factor that mediates estrogen action in target tissue. Several common polymorphisms of the ERα gene have been reported to be associated with alterations in receptor expression in breast cancer. MATERIALS AND METHODS: A case-control study was designed to compare 250 breast cancer patients with 250 age-matched healthy controls. The frequency distribution of PvuII polymorphism in the ERα gene was assessed by PCR-RFLP method. RESULTS: The frequency of the PP genotype (35.3%) was increased significantly in breast cancer patients when compared to controls (19.8%), with a corresponding increase in P allele frequency (χ2= 16.4; P = 0.0003). The OR for genotypes PP vs. Pp was 1.989 (95% CI: 1.2708 to 3.113). Premenopausal women with breast cancer had an elevated frequency of the PP genotype (22.8%) as compared to postmenopausal women (16.8%). The frequency of the PP genotype was increased in patients positive for ER and HER-2/neu as compared to those with receptor-negative status. The pp and p allele frequencies were increased in progesterone-receptor-negative status. When stage of the disease was considered, both Pp and pp genotype frequencies were elevated in patients with advanced stage breast cancer. The frequency of the P allele and PP genotype frequencies tended to increase with increase in body mass index, whereas the Pp genotype frequency was elevated only in obese patients. The reverse was observed in the case of pp genotype frequency. CONCLUSION: The study thus highlighted the influence of ERα PvuII polymorphism on the development and progression of breast cancer.

Clinical Analysis and Prognostic Significance of Menopausal Status in Breast Cancer

The influence of age and menopausal status at diagnosis on the prognosis of patients with primary breast cancer remains controversial. Some studies have found that younger patients have worse clinical outcomes than older patients, others have reported that younger patients have a more favorable outcome, and others have found no relation with age. We analyzed the effects of menopausal status in the survival of patients with operable breast cancer and estimated the correlations between the menopausal status and other established prognostic factors. We reviewed the records of the patients who had been operated on at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University during the past 10 years (1985~1996). The results were as follows: 1) The peak age group was the fifth decade (27%), and all of patients, except one, were females. 2) The most common symptom was a palpable breast mass with or without pain (88%). 3) Most patients (72.8%) visited within 6 months of the first appearance of a symptom, and the most frequent tumor size was 2~5 cm in diameter (58.9%). 4) Most of the primary tumors were located in the upper outer quadrant (61%); tumors located in the lower outer quadrant were rare (3%). 5) The most common TNM stage group was stage II (54.1%), and there was no difference of distribution between the premenopause and the postmenopause groups. 6) The common pathologic cancer types were infiltrating ductal cancer (73.8%), medullary cancer (9.3%), mucinous cancer (8.3%). 7) Axillary lymph-node metastasis was present in 58 cases (62.4%). 8) The overall five-year survival rate for all patients was 43.9%. 9) The five-year survival rates of the 38 premenopausal patients and the 38 postmenopausal patients were 42.4% and 35.8%, respectively, but there was no statically significant difference between the two groups. 10) Menopausal status did not significantly correlated with tumor size, tumor location, lymph-node metastasis or TNM stage. In conclusion, the menopausal status may be not correlated with the prognosis in breast cancer However, the effect of menopausal status on the prognosis of patients with breast cancer needs to be investigated for a large papulation of breast cancer patients.