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Pre-treatment circulating reproductive hormones levels predict pathological and survival outcomes in breast cancer submitted to neoadjuvant chemotherapy

  • Original Article
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International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to evaluate the correlation of pre-treatment circulating reproductive hormones levels with pathological and survival outcomes in breast cancer patients received neoadjuvant chemotherapy (NAC).

Methods

Information from 196 premenopausal and 137 postmenopausal breast cancer patients who received NAC were retrospectively analyzed. Treatment response to NAC, with odds ratios (OR) and 95% confidence intervals (95% CI) was estimated using logistic regression adjusted for key confounders. Survival outcomes with hazard ratios (HR) and 95% CI were estimated using Cox regression adjusted for key confounders. The Kaplan–Meier method was applied in the survival analysis.

Results

Premenopausal patients with lower testosterone levels (OR = 0.996, 95% CI 0.992–0.999, P = 0.026), and postmenopausal patients with higher follicle-stimulating hormone (FSH) levels (OR = 1.045, 95% CI 1.014–1.077, P = 0.005) were likely to achieve pathological complete response (pCR). In multivariate survival analysis, the lowest tertile (T) progesterone was associated with worse overall survival (OS) in premenopausal patients (T2 vs T1, HR = 0.113, 95% CI 0.013–0.953, P = 0.045; T3 vs T1, HR = 0.109, 95% CI 0.013–0.916, P = 0.041). Premenopausal patients with the lowest tertile progesterone exhibited worse 3-year OS compared with those with higher tertiles (72.9% vs 97.4%, log-rank, P = 0.007).

Conclusion

Pre-treatment testosterone and FSH are significant independent predictors for pCR to NAC in premenopausal and postmenopausal patients, respectively. Low progesterone levels are correlated with worse OS in premenopausal patients. These findings may provide a theoretical basis for pre-operative endocrine therapy combined with NAC in breast cancer.

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Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

Abbreviations

NAC:

Neoadjuvant chemotherapy

OR:

Odds ratio

CI:

Confidence interval

HR:

Hazard ratio

pCR:

Pathological complete response

T:

Tertile

OS:

Overall survival

RFS:

Relapse-free survival

FSH:

Follicle-stimulating hormone

LH:

Luteinizing hormone

SHBG:

 Sex hormone-binding globulin

ER:

Estrogen receptor

PR:

Progesterone receptor

AR:

Androgen receptor

AI:

Aromatase inhibitor

PRL:

Prolactin

DHEAS:

Dehydroepiandrosterone sulfate

FAI:

Free androgen index

HER2:

Human epidermal growth factor receptor 2

IHC:

Immunohistochemistry

CEP17:

Chromosome enumeration probe 17

FISH:

Fluorescence in situ Hybridization

IQR:

Interquartile range

BMI:

Body mass index

GnRH:

Gonadotrophin-releasing hormone

FSHR:

Follicle-stimulating hormone receptor

cCR:

Clinical complete response

cPR:

Clinical partial response

cSD:

Clinical stable disease

cPD:

Clinical progressive disease

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Acknowledgements

The authors thank Yinan Wu for her contribution to the data collection.

Funding

This work was funded by the National Natural Science Foundation of China (No. 81772979 and 81472658). The funding source had no role in the study design, data collection, data analysis, data interpretation, or the writing of the report.

Author information

Authors and Affiliations

  1. Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China

    Ailin Lan, Yudi Jin, Yu Wang, Yihua Wang, Nan Ding, Yuran Dai, Linshan Jiang, Zhenrong Tang, Yang Peng & Shengchun Liu

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  1. Ailin Lan
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  2. Yudi Jin
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  3. Yu Wang
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Contributions

SL and AL are the guarantors of integrity of the entire study; AL, YJ, YW and SL designed the study concepts/study design; AL, YHW, ND, YW, YJ, ZT, YP, YD, and LJ participated in the data acquisition or data analysis/interpretation; AL, YJ, YW and SL participated in the drafting or revising of manuscript for important intellectual content; all authors have approved the final version of submitted manuscript; AL and SL agreed to ensure any questions related to the work are appropriately resolved; AL and YW performed literature research; AL performed statistical analysis; AL participated in the manuscript editing.

Corresponding author

Correspondence to Shengchun Liu.

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Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval

Approval was obtained from the ethics committee of First Affiliated Hospital of Chongqing Medical University (ID: No. 2021-218).

Consent to participate

As this study had a retrospective observational design and the data are anonymous, the requirement for informed consent was waived by the hospital.

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Not applicable.

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Lan, A., Jin, Y., Wang, Y. et al. Pre-treatment circulating reproductive hormones levels predict pathological and survival outcomes in breast cancer submitted to neoadjuvant chemotherapy. Int J Clin Oncol 27, 899–910 (2022). https://doi.org/10.1007/s10147-022-02141-9

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  • DOI: https://doi.org/10.1007/s10147-022-02141-9

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