Chemotherapy Effect on Estradiol Levels in Patients with Triple-negative Breast Cancer: A Clinical Prospective Study from Indonesia

Rizka Vinkan Septiani; Widyanti Soewoto; Ida Bagus Budhi

doi:10.3889/oamjms.2022.6882

Authors

Rizka Vinkan Septiani Department of Surgery, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia https://orcid.org/0000-0001-7730-3024
Widyanti Soewoto Department of Surgery, Oncology Division, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia https://orcid.org/0000-0003-2513-5801
Ida Bagus Budhi Department of Surgery, Digestive Division, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia https://orcid.org/0000-0002-0310-7415

DOI:

https://doi.org/10.3889/oamjms.2022.6882

Keywords:

Triple-negative breast cancer, Estradiol level, Chemotherapy, Prospective study

Abstract

Research Background: This study aimed to scrutinize the chemotherapy’s effect on estradiol levels in patients with triple-negative breast cancer (TNBC) at low-resource country. Methods: This prospective analytic observational cohort study involved patients with TNBC who had undergone surgery and had never received chemotherapy or hormonal therapy before. Patients were checked for estradiol levels before and after chemotherapy. This study was conducted at the Surgical Oncology Department of Regional Public Hospital Dr. Moewardi, Surakarta Indonesia, from April 2020 to March 2021. Descriptive data were presented in a frequency table based on age, menopausal status, parity status, breastfeeding status, hormonal contraception, hormonal contraception duration, family history, stage, and histological grade. Differences in estradiol changes before and after chemotherapy (mean+sd) were then reported.

Results: From a total of 23 patients, 21 patients (91.3%) experienced a decrease in estradiol levels, while two patients (8.7%) underwent an increase in serum estradiol levels after chemotherapy. The mean decrease was 11.57 pg/ml. The two samples that experienced an increase in estradiol levels had a mean increase of 16.5 pg/ml. There was a significant difference between estradiol levels before and after undergoing chemotherapy, with p-value=0.001.

Conclusions: In this research, chemotherapy reduced estradiol levels in TNBC patients. Statistically significant reductions in estradiol levels were based on the disease stage.

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References

Putra MD, Yarso KY, Wasita B. Neoadjuvant chemotherapy effect on predictive value of sentinel lymph node biopsy using single method methylene blue in breast cancer patients at low-resource country. Open Access Maced J Med Sci. 2021;9:191-5.

Lønning PE, Haynes BP, Straume AH, Dunbier A, Helle H, Knappskog S, et al. Exploring breast cancer estrogen disposition: The basis for endocrine manipulation. Clin Cancer Res. 2011;17(15);4948-58. https://doi.org/10.1158/1078-0432.CCR-11-0043 PMid:21791635

Soewoto W, Mudigdo A, Aryandono T, Dirgahayu P. Correlation between duration of estrogen exposure with grading of breast cancer. Bali Med J. 2018;7(3):778-81.

Key TJ. Endogenous oestrogens and breast cancer risk in premenopausal and postmenopausal women. Steroids. 2011;76(8):812-5. https://doi.org/10.1016/j.steroids.2011.02.029 PMid:21477610

Soewoto W, Mudigdo A, Aryandono T, Dirgahayu P. The Association Between Estradiol Level, Remission, and Survival In Breast Cancer Patients At Dr. Moewardi Hospital, Surakarta, Central Java. Indonesia: Mid-International Conference in Public Health; 2018. https://doi.org/10.26911/mid.icph.2018.01.57

Lebert JM, Lester R, Powell E, Seal M, McCarthy J. Advances in the systemic treatment of triple-negative breast cancer. Curr Oncol. 2018;25(1):S142-50. https://doi.org/10.3747/co.25.3954 PMid:29910657

Collignon J, Lousberg L, Schroeder H, Jerusalem G. Triple-negative breast cancer: Treatment challenges and solutions. Breast Cancer. 2016;8:93-107. https://doi.org/10.2147/BCTT.S69488 PMid:27284266

Almuradova DM. The role of chemotherapy in triple negative breast cancer. Orthop Surg Orthop Care Int J 2018;2(2):000533.

IBM Corp. IBM SPSS Statistics for Windows, Version 25.0. Released. Armonk, NY: IBM Corp; 2017.

Shinde SS, Forman MR, Kuerer HM, Yan K, Peintinger F, Hunt KK, et al. Higher parity and shorter breastfeeding duration: Association with triple-negative phenotype of breast cancer. Cancer. 2010;116(21):4933-43. https://doi.org/10.1002/cncr.25443 PMid:20665494

Mørch LS, Skovlund CW, Hannaford PC, Iversen L, Fielding S, Lidegaard Ø. Contemporary hormonal contraception and the risk of breast cancer. N Engl J Med. 2017;377(23):2228-39. https://doi.org/10.1056/NEJMoa1700732

Mouh FZ, Slaoui M, Razine R, Mzibri ME, Amrani M. Clinicopathological, treatment and event-free survival characteristics in a moroccan population of triple-negative breast cancer. Breast Cancer (Auckl). 2020;14: 1-10. https://doi.org/10.1177/1178223420906428 PMid:32425539

Pareja F, Geyer FC, Marchiò C, Burke KA, Weigelt B, Reis- Filho JS. Triple-negative breast cancer: The importance of molecular and histologic subtyping, and recognition of low-grade variants. NPJ Breast Cancer. 2016;2:16036. https://doi.org/10.1038/npjbcancer.2016.36 PMid:28721389

Phipps AI, Buist DS, Malone KE, Barlow WE, Barlow WE, Porter PL, Kerlikowske K, et al. Family history of breast cancer in first-degree relatives and triple-negative breast cancer risk. Breast Cancer Res Treat. 2011;126(3):671-8. https://doi.org/10.1007/s10549-010- 1148-9 PMid:20814817

Papakonstantinou A, Foukakis T, Rodriguez-Wallberg KA, Bergh J. Is estradiol monitoring necessary in women receiving ovarian suppression for breast cancer? J Clin Oncol. 2016;34(14):1573-9. PMid:26951320

Coscia EB, Sabha M, Gerenutti M, Groppo FC, Bergamaschi CC. Estrone and estradiol levels in breast cancer patients using anastrozole are not related to bodymass index. Rev Bras Ginecol Obstet. 2017;39(1):14-20. https://doi.org/10.1055/s-0036-1597974 PMid:28187491

Pribylova O, Springer D, Svobodnik A, Kyr M, Zima T, Petruzelka L. Influence of chemotherapy to hormonal levels in postmenopausal breast cancer patients. Neoplasma. 2008;55(4):294-8. PMid:18505339

Braverman AS, Sawhney H, Tendler A, Patel N, Rao S, El-Tamer M, et al. Serum estradiol above the postmenopausal level 50 after chemotherapy-induced amenorrhea in breast cancer patients. Therapy. 2006;3(5):609-12. https://doi.org/10.1586/14750708.3.5.609

Zhen H, Fan G, Xiaojun Z, Jia M, Haibo Y, Yarong Y, et al. Anthracycline chemotherapy in treatuing advanced breast cancer and its effect on estradiol and tumor size. Indian J Pharm Sci 2020;82(1):163.

Oktem O, Oktay K. Impact of previous chemotherapy on ovarian production of estradiol, progesterone, and AMH: An in vitro controlled study. Fertil Steril. 2007;88(1):38.

Yu B, Hershman DL, Ferin MJ, Douglas N, Nakhuda GS, Lobo RA, et al. Dissociation of mullerian inhibiting substance (MIS) and estradiol (E2) levels after chemotherapy in young women with breast cancer. Fertil Steril. 2008;90(1):457. https://doi.org/10.1016/J.Fertnstert.2008.07.1232

Aboulkheyr EH, Aref AR, Granpayeh L, Ebrahimi M, Baharvand H. Evaluation of tumor response to adjuvant treatments using an ex vivo culture of breast carcinoma spheroids in a microfluidic device. MedRxiv. 2021. https://doi.org/10.1101/2021.05.19.21257378.

Manna S, Holz MK. Tamoxifen action in ER-negative breast cancer. Sign Transduct Insight. 2016;5:1-7. PMid:26989346