Lack of evidence that progesterone in ovulatory cycles causes breast cancer.

IF 2.9 4区 医学 Q1 OBSTETRICS & GYNECOLOGY
Climacteric Pub Date : 2023-12-01 Epub Date: 2023-09-06 DOI:10.1080/13697137.2023.2249813
A Gompel, V Seifert-Klauss, J A Simon, J C Prior
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引用次数: 0

Abstract

A recent Perspective article asserted that progesterone secretion during ovulatory cycles is the cause of breast cancer. However, we challenge most of the evidence developed in this publication. First, there is a lack of evidence that progesterone is mutagenic for breast cells. Cause of a cancer should mean initiation by mutation, as opposed to promotion. Second, subclinical ovulatory disturbances occur rather frequently in normal-length menstrual cycles. Third, the authors attribute a potential carcinogenic effect to progesterone secreted during menstrual cycles but not to progesterone during pregnancy. They did not discuss breast cancer evidence from progesterone/progestin therapeutics. They argue that in genetic primary amenorrhea, a hypothetic lower risk of breast cancer could be due to the lack of progesterone, despite the progesterone/progestin in hormone replacements these women receive. Fourth, they advocate a regulatory effect of progesterone on several genes potentially involved in cancer genesis. In particular, they attribute a lower risk of breast cancer in women with Mayer-Rokitansky-Küster-Hauser syndrome to a defect in the progesterone-stimulated Wnt4 gene. However, this defect is only present in a small subset. Thus, the postulated progesterone breast cancer risk is unconvincing, which we discuss point by point in this commentary.

缺乏证据表明排卵周期中的黄体酮会导致乳腺癌。
《透视》杂志最近的一篇文章断言,排卵周期中黄体酮的分泌是导致乳腺癌的原因。然而,我们对本出版物中提出的大多数证据提出质疑。首先,没有证据表明黄体酮对乳腺细胞具有诱变作用。癌症的起因应该是由突变引起,而不是由促进引起。其次,亚临床排卵障碍在正常长度的月经周期中经常发生。第三,作者将潜在的致癌作用归因于月经周期分泌的黄体酮,而不是怀孕期间的黄体酮。他们没有讨论孕酮/黄体酮治疗乳腺癌的证据。他们认为,在遗传性原发性闭经中,假设患乳腺癌的风险较低可能是由于缺乏孕酮,尽管这些女性接受的激素替代品中含有孕酮/黄体酮。第四,他们主张黄体酮对几个可能参与癌症发生的基因有调节作用。特别是,他们将患有mayer - rokitansky - k ster- hauser综合征的女性患乳腺癌的风险较低归因于黄体酮刺激的Wnt4基因的缺陷。然而,这种缺陷只存在于一个小子集中。因此,假设的孕激素乳腺癌风险是不令人信服的,我们在这篇评论中逐点讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Climacteric
Climacteric 医学-妇产科学
CiteScore
1.70
自引率
7.10%
发文量
53
审稿时长
1 months
期刊介绍: Climacteric is the official journal of the International Menopause Society (IMS). As an international peer-reviewed journal it publishes original research and reviews of all aspects of aging in women. Climacteric was founded by the IMS in 1998 and today has become a leading journal in the publication of peer-reviewed papers on the menopause, climacteric and mid-life health. Topics covered include endocrine changes, symptoms attributed to the menopause and their treatment, hormone replacement and alternative therapies, lifestyles, and the counselling and education of peri- and postmenopausal women. Climacteric, published bimonthly, also features regular invited reviews, editorials and commentaries on recent developments. The editorial review board of Climacteric includes leading scientific and clinical experts in the field of midlife medicine and research and is headed by its Editor-in-Chief, Professor Rod Baber of Australia. He and his team of Associate Editors act independently to set a clear editorial policy, co-ordinate peer review, and ensure a rapid response to submitted papers.
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