Individuals with PCOS may be at a slightly increased risk for certain types of breast cancer.[1],[2],[3] In this article we explore the link between PCOS and breast cancer.
PCOS is associated with elevated levels of androgens[4], sex hormones that are produced in the ovaries, start at puberty and play a key role in reproductive health.[5] Find out more about PCOS and Androgen Excess.
In the case of estrogen receptor (ER) positive breast cancer, individuals with PCOS are at slightly increased (1.09x) the risk relative to individuals without PCOS:[6],[7]
Androgens, specifically testosterone, are partially converted to estradiol in adipose (fat) and bone tissue[8] and dihydrotestosterone (DHT)[9] in the skin and liver[10];
Elevated levels of estradiol lead to increased binding of estradiol to its receptor[11] within breast cancer cells as well as cells within the endometrium, ovary and hypothalamus[12]; and
Increased binding of estradiol in breast cancer cells leads to increased proliferation of these cells.[13]
In the care of estrogen receptor (IR) negative breast cancer, individuals with PCOS are at slightly increased (1.02x) the risk relative to individuals without PCOS:[14]
High androgen levels lead to increased production of epidermal growth factor (EGF) and related peptides[15] that are involved in the regulation of cell proliferation[16];
Elevated level of these peptides results in activation of EGFR and HER2,[17] both involved in stimulating cell proliferation and common targets for many cancer drugs[18];
Increased activation of these peptides leads to increased cell proliferation[19] with both EGFR and HER2 observed in up to 30% of breast cancers and associated with poor outcomes.[20]
There are a variety of other risk factors for breast cancer, including:[21]
Increasing age;
Inherited genetic variants including BRCA1 and BRCA2, genetic variants also linked with increased ovarian cancer risk;
Early onset of menstruation and / or late onset of menopause;
Having dense breasts (almost 50% of AFAB individuals)[22], making it difficult to detect tumors via mammogram;
Personal history of breast cancer or certain non-cancerous breast diseases;
Family history of breast or ovarian cancers;
Previous treatment using radiation therapy before the age of 30; and
Exposure to diethylstilbestrol (DES), a drug previously given to women (between 1940 and 1971 in the US) to prevent miscarriage.
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PARTNER SPOTLIGHT
Palpa is a breast-shaped device that contains a lump inside. The device is filled with shower gel and with it, women can practice self-examination outside their bodies and distinguish learn how does an anomaly feel like. Palpa also works as a soap dispenser, so when women practice with it, soap is released for a better sliding and skinsense over their breast while examining.
Sources
[1] https://pubmed.ncbi.nlm.nih.gov/30403656/
[2] https://pubmed.ncbi.nlm.nih.gov/33128677/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028643/
[4] https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics/
[5] https://my.clevelandclinic.org/health/articles/22002-androgens
[6] https://pubmed.ncbi.nlm.nih.gov/30403656/
[7] https://pubmed.ncbi.nlm.nih.gov/33128677/
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533072/
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016457/
[10] https://my.clevelandclinic.org/health/articles/24555-dht-dihydrotestosterone
[11] https://pubmed.ncbi.nlm.nih.gov/33128677/
[12] https://en.wikipedia.org/wiki/Estrogen_receptor
[13] https://pubmed.ncbi.nlm.nih.gov/30403656/
[14] https://pubmed.ncbi.nlm.nih.gov/33128677/
[15] https://pubmed.ncbi.nlm.nih.gov/30403656/
[16] https://pubmed.ncbi.nlm.nih.gov/7640657/
[17] https://pubmed.ncbi.nlm.nih.gov/30403656/
[18] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215954/
[19] https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941
[20] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215954/
[21] https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm
[22] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443857/actors.html
Complications – Cancer