Plasma testosterone and prognosis of postmenopausal breast cancer patients

Andrea Micheli, Elisabetta Meneghini, Giorgio Secreto, Franco Berrino, Elisabetta Venturelli, Adalberto Cavalleri, Tiziana Camerini, Maria G. Di Mauro, Elena Cavadini, Giuseppe De Palo, Umberto Veronesi, Franca Formelli

Research output: Contribution to journalArticlepeer-review


Purpose: High endogenous testosterone is associated with increased breast cancer (BC) risk. We designed this study specifically to assess the long-term prognostic role of testosterone in a cohort of postmenopausal BC patients. Patients and Methods: We considered 194 postmenopausal women, operated on for early BC (T1-2N0M0), who never received chemotherapy or hormonal therapy, and who participated in a fenretinide BC prevention trial as untreated controls. Blood samples were collected 3 months (median) after surgery; plasma samples, stored at -80°C, were radioimmunoassayed for testosterone. Median follow-up was 14 years. The main end point was any cancer event. Event-free survival was estimated by the Kaplan-Meier method. Hazard ratios (HRs) of events by testosterone level were estimated by the Cox model, adjusting for age, tumor size, and histology. Results: Patients with high testosterone (≥ 0.40 ng/mL, median of distribution) had significantly lower event-free survival than those with low testosterone (log-rank P = .004). The adjusted HR of patients with high versus low testosterone was 2.05 (95% CI, 1.28 to 3.27). High testosterone was also associated with a significantly higher risk of BC events (relapse and second primary) with an adjusted HR of 1.77 (95% CI, 1.06 to 2.96). Eleven second primaries (non-BC) occurred in the high-testosterone group, four in the low-testosterone group. Conclusion: High plasma testosterone strongly predicts poorer prognosis in postmenopausal BC patients not administered adjuvant therapy. Testosterone levels should be determined as part of the prognostic work-up.

Original languageEnglish
Pages (from-to)2685-2690
Number of pages6
JournalJournal of Clinical Oncology
Issue number19
Publication statusPublished - Jul 1 2007

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)


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