Plasma hormones and breast disease

McFadyen, Ida J (1984) Plasma hormones and breast disease. MD thesis, University of Glasgow.

Abstract

The aim of this study was to conduct a detailed examination of hormone concentrations in the plasma of subjects with breast disease. In particular, women with breast cancer were investigated, and men with gynaecomastia. Plasma oestradiol-17beta, testosterone, luteinizing hormone, follicular stimulating hormone and prolactin levels were studied in women with breast cancer. All plasma hormone concentrations were within the normal range although plasma testosterone levels were higher in women with breast cancer than in normal women matched for age, parity and menstrual status. Pituitary releasing hormones were used to induce a rise in the levels of plasma LH, FSH, growth hormone (GH), thyroid stimulating hormone (TSH) and prolactin concentrations in patients with breast cancer and the various pituitary function tests were compared. It was shown that luteinizing hormone releasing hormone (LHRH) induced a rise in the levels of plasma LH and FSH and thyrotrophic releasing hormone (TRH), a rise in plasma TSH and prolactin. The addition of TRH to LHRH did not affect the levels of plasma LH and FSH above that produced by LHRH alone. TRH led to a higher elevation of plasma prolactin levels than chiorpromazine. A test consisting of the administration of LHRH, TRH and insulin by infusion was found to be the most suitable for studying pituitary function in women with breast cancer undergoing yttrium implantation of the pituitary. This test was then used to assess the pituitary function after yttrium implant. Response of each hormone to its own releasing hormone was used to assess the degree of pituitary ablation obtained which, in turn, was correlated with clinical response. The results showed that the more complete the ablation, the more likely there was to be a clinical response. This test of pituitary function was also used to assess the effect of quadruple chemotherapy on pituitary function. The results showed that in women with advanced breast cancer chemotherapy did not have a demonstrable effect on pituitary function. The effect of administration of the hormonal drugs - an antioestrogen (tamoxifen) and a synthetic oestrogen (stilboestrol) on plasma FSH, oestradiol-17B, testosterone and prolactin levels were examined. Both drugs depressed plasma FSH levels, stilboestrol having a greater effect than tamoxifen. Stilboestrol also induced elevation of plasma prolactin concentrations. The effect of these drugs on the concentrations of plasma hormones was, however, not related to the clinical response of the disease. These studies showed a pulsatile pattern of concentrations of plasma luteinizing hormone (LH) in normal young men, which was absent in both young and old men with gynaecomastia and in normal old men. In comparison to normal young men, young men with gynaecomastia had a lower plasma LH level and consequently a lowered ratio of LH to follicle stimulating hormone (FSH) LH/FSH ratio, while in comparison with normal old men older men with gynaecomastia had a normal LH/FSH ratio, but raised values of LH and FSH. This group of older men with gynaecomastia also had higher plasma oestradiol-17beta (E2) levels and a raised oestradiol-17beta testosterone ratio, when compared with normal men of a similar age. From these results, it would seem that the causes of breast disease are multifactorial which will be solved only after many related aspects have been considered and discussed and further research carried out. This thesis seeks no more than to make a contribution to this discussion; nevertheless it is felt that certain aspects of breast disease have been clarified and that sampling methods have been identified to give a more accurate and realistic indication of plasma hormone levels. Nothing discovered in the course of this work or in the study of the literature, discounts a hormonal contribution to the cause of breast cancer. It is believed that in the further refinement and investigation of the full role of these plasma hormones in male and female breast disease, will the cause of breast cancer be eventually clarified.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Keywords: Medicine, Endocrinology
• Date of Award: 1984
• Depositing User: Enlighten Team
• Unique ID: glathesis:1984-76546
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 19 Nov 2019 14:10
• Last Modified: 19 Nov 2019 14:10
• URI: https://theses.gla.ac.uk/id/eprint/76546