This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.
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Introduction: Androgens (such as testosterone) are natural hormones. They are important in sexual development in both men and women. In women, androgens are produced in small amounts by the ovaries and the adrenal glands. Similar to higher blood estrogen levels, higher amounts of androgens in the blood may be linked to an increased risk of breast cancer in women.
Testosterone
Of the androgens that have been studied in relation to breast cancer risk, the most data are available for testosterone. Studies show higher blood levels of testosterone may increase the risk of breast cancer in postmenopausal women. And, although findings are limited, there is some evidence that higher blood levels of testosterone may also increase breast cancer risk in premenopausal women.
Blood androgens and postmenopausal hormone use
Most of the studies below excluded women who were taking postmenopausal hormones at the time of the blood collection. Certain types of postmenopausal hormones might mask the full effect natural blood testosterone levels have on breast cancer risk. By looking only at women who do not take (or who have never taken) postmenopausal hormones, researchers may see more clearly how blood androgen levels affect breast cancer risk.
Learn more about blood androgen levels and breast cancer risk.
Learn about the strengths and weaknesses of different types of studies.
See how this risk factor compares with other risk factors for breast cancer.
Study selection criteria: Nested case-control studies, case-control studies and pooled analyses with at least 100 breast cancer cases.
Table note: Odds ratios above 1 indicate increased risk. Odds ratios below 1 indicate decreased risk.
Risks related to total testosterone levels (unless noted) are shown in this table. Although free testosterone and/or bioavailable testosterone may also be related to breast cancer risk, many studies have not measured these and data are limited at this time.
Study
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Study Population
(number of participants)
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Risk of Breast Cancer in Women with Higher Testosterone Levels
Compared to Women with Lower Testosterone Levels
Odds Ratio (95% CI)
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Premenopausal
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Postmenopausal
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Nested case-control studies
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Cases
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Controls
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Nurses' Health Study [1]
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770
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1,414
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1.5 (1.2-1.9)*
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EPIC cohort [2-3]
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677
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1,309
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1.85 (1.33–2.57)
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370
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726
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1.73 (1.16-2.57)
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Women’s Health Initiative Observational Study [4]
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317
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594
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ER+ cancers:
1.55 (0.92-2.61)†
ER- cancers:
0.51 (0.28-0.94)†
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NYU Women’s Health Study [5-6]
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297
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563
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2.05 (1.19-3.53)
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274
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683
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1.5 (1.1-2.2)
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UK Collaborative Trial of Ovarian Cancer Screening [7]
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200
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400
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2.15 (1.26-3.71)
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Nurses' Health Study II [8]
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197
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394
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2.0 (1.1-3.6)‡
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Melbourne Collaborative Cohort Study [9]
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197
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857
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1.25 (0.78-2.01)
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Manjer et al. [10]
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173
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438
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1.87 (1.08-3.25)
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ORDET cohort [11]
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165
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672
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3.28 (1.93-5.55)
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Case-control studies
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Wang et al. [12]
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367
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367
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1.41 (0.61-3.26)§
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2.83 (1.20-6.67)
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Yu et al. [13]
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300
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300
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2.01 (0.96-4.21)
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2.40 (1.11-5.21)
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Sturgeon et al. [14]
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169
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195
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1.12 (0.6-2.5)
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Pooled analyses
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Cases
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Controls
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The Endogenous Hormones and Breast Cancer Collaborative Group [15]
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663
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1,765
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2.22 (1.59-3.10)
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ER+ = Estrogen receptor-positive
ER- = Estrogen receptor-negative
PR+ = Progesterone receptor-positive
PR- = Progesterone receptor-negative
* Relative risk for ER+/PR+ breast cancers was 1.8 (1.3-2.5). Relative risk for ER-/PR- breast cancers was 0.6 (0.3-1.2).
† Results for blood levels of bioavailable testosterone.
‡ For testosterone blood levels measured in the luteal phase of a woman’s menstrual cycle. Testosterone blood levels as measured in the early follicular stage, the risk was not significant, RR=1.8 (0.9-3.4).
§ For testosterone blood levels measured in the luteal phase of a woman’s menstrual cycle. Testosterone blood levels as measured in the early follicular stage, the risk was also not significant, RR=0.45 (0.17-1.19).
References
- Zhang X, Tworoger SS, Eliassen AH, Hankinson SE. Postmenopausal plasma sex hormone levels and breast cancer risk over 20 years of follow-up. Breast Cancer Res Treat. 137(3):883-92, 2013.
- Kaaks R, Rinaldi S, Key TJ, et al. Postmenopausal serum androgens, oestrogens and breast cancer risk: the European prospective investigation into cancer and nutrition. Endocr Relat Cancer. 12(4):1071-82, 2005.
- Kaaks R, Berrino F, Key T, et al. Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst. 97(10):755-65, 2005.
- Farhat GN, Cummings SR, Chlebowski RT, et al. Sex hormone levels and risks of estrogen receptor-negative and estrogen receptor-positive breast cancers. J Natl Cancer Inst. 103(7):562-70, 2011.
- Zeleniuch-Jacquotte A, Shore RE, Koenig KL, et al. Postmenopausal levels of oestrogen, androgen, and SHBG and breast cancer: long-term results of a prospective study. Br J Cancer. 90(1):153-9, 2004.
- Zeleniuch-Jacquotte A, Afanasyeva Y, Kaaks R, et al. Premenopausal serum androgens and breast cancer risk: a nested case-control study. Breast Cancer Res. 14(1):R32, 2012.
- Fourkala EO, Zaikin A, Burnell M, et al. Association of serum sex steroid receptor bioactivity and sex steroid hormones with breast cancer risk in postmenopausal women. Endocr Relat Cancer. 19(2):137-47, 2012.
- Eliassen AH, Missmer SA, Tworoger SS, et al. Endogenous steroid hormone concentrations and risk of breast cancer among premenopausal women. J Natl Cancer Inst. 98(19):1406-15, 2006.
- Baglietto L, Severi G, English DR, et al. Circulating steroid hormone levels and risk of breast cancer for postmenopausal women. Cancer Epidemiol Biomarkers Prev. 19(2):492-502, 2010.
- Manjer J, Johansson R, Berglund G, et al. Postmenopausal breast cancer risk in relation to sex steroid hormones, prolactin and SHBG (Sweden). Cancer Causes Control. 14(7):599-607, 2003.
- Sieri S, Krogh V, Bolelli G, et al. Sex hormone levels, breast cancer risk, and cancer receptor status in postmenopausal women: the ORDET cohort. Cancer Epidemiol Biomarkers Prev. 18(1):169-76, 2009.
- Wang B, Mi M, Wang J, et al. Does the increase of endogenous steroid hormone levels also affect breast cancer risk in Chinese women? A case-control study in Chongqing, China. Int J Cancer. 124(8):1892-9, 2009.
- Yu H, Shu XO, Shi R, et al. Plasma sex steroid hormones and breast cancer risk in Chinese women. Int J Cancer. 105(1):92-7, 2003.
- Sturgeon SR, Potischman N, Malone KE, et al. Serum levels of sex hormones and breast cancer risk in premenopausal women: a case-control study (USA). Cancer Causes Control. 15(1):45-53, 2004.
- Key T, Appleby P, Barnes I, Reeves G for the Endogenous Hormones and Breast Cancer Collaborative Group. Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst. 94(8):606-16, 2002.
Updated 03/14/13
