Skip to main content

COVID-19 Resources

What people with cancer should know:

Guidance for cancer researchers:

Get the latest public health information from CDC:

Get the latest research information from NIH:

Grant Details

Grant Number: 5R01CA158328-02 Interpret this number
Primary Investigator: Santen, Richard
Organization: University Of Virginia
Project Title: Development of Breast Cancer Risk Model Based on Estrogen Metabolomics
Fiscal Year: 2013


DESCRIPTION (provided by applicant): Development of breast cancer risk model based on estrogen metabolomics. Anti-estrogens provide an effective strategy to prevent breast cancer but eligible women generally decline therapy because of unfavorable benefit/risk ratios. Data from prevention studies indicate that fifty women need to be treated with these agents for five years to prevent one breast cancer. To improve the ratio of benefit to risk, a more powerful method of identifying women at very high risk of developing breast cancer is urgently needed. Prediction of disease risk is best grounded on factors involved in its pathogenesis. We propose an integrative hypothesis regarding the carcinogenic process which involves both estrogen receptor alpha (ER¿) dependent as well as ER¿ independent actions. Through ER¿, estradiol (E2) stimulates proliferation with resultant replicative mutations and promotes the growth of cells harboring those mutations. Independent of ER¿, estrogen metabolites both form unstable DNA adducts and generate oxygen free radicals thorough redox cycling to initiate mutations. Several genetically regulated enzymes modulate estrogen metabolism and the process of repair of estrogen induced mutations. Our innovative hypothesis regarding estrogen induced breast cancer integrates all of these processes into a model of carcinogenesis and implicates the entire estrogen metabolome in the genesis of breast cancer. These concepts suggest that measurement of estrogen metabolomics should provide a powerful, mechanism-based method of predicting who will develop breast cancer. Metabolomic assessment entails quantitative measurement of aromatizable androgens, estrogens, and their metabolites and SNPs from enzymes regulating the metabolic process. Several important factors have recently come together to enable us to test this concept. A new, state of the art, mass spectrometer coupled with an ultra-performance liquid chromatography system makes it possible for the first time to measure all estrogen metabolites in small amounts of serum. We can measure SNPs which involve enzymes regulating estrogen metabolism and have been shown to correlate with breast cancer risk. To develop a model, we will utilize serum samples and risk factor data from 3 cohort studies (NYU, Clue I and II, and Rancho Bernardo) which had collected blood from women 5-20 years ago and then followed them prospectively for development of breast cancer. Availability of these techniques, samples and risk factor data allows performance of a nested case-control study to develop a new, more powerful risk prediction model. We will then validate this model in a completely independent data set involving the French Teacher's Study. We anticipate reducing the number of women needed to be treated to prevent one breast cancer from 50 to 13 with tamoxifen and to 5.with aromatase inhibitors.


Analysis of estrogens and androgens in postmenopausal serum and plasma by liquid chromatography-mass spectrometry.
Authors: Wang Q. , Bottalico L. , Mesaros C. , Blair I.A. .
Source: Steroids, 2015 Jul; 99(Pt A), p. 76-83.
EPub date: 2014-08-20.
PMID: 25150018
Related Citations

Estrogens and Their Genotoxic Metabolites Are Increased in Obese Prepubertal Girls.
Authors: Mauras N. , Santen R.J. , Colón-Otero G. , Hossain J. , Wang Q. , Mesaros C. , Blair I.A. .
Source: The Journal of clinical endocrinology and metabolism, 2015 Jun; 100(6), p. 2322-8.
EPub date: 2015-04-09.
PMID: 25856214
Related Citations

Ultrasensitive quantification of serum estrogens in postmenopausal women and older men by liquid chromatography-tandem mass spectrometry.
Authors: Wang Q. , Rangiah K. , Mesaros C. , Snyder N.W. , Vachani A. , Song H. , Blair I.A. .
Source: Steroids, 2015 Apr; 96, p. 140-52.
EPub date: 2015-01-29.
PMID: 25637677
Related Citations

Translational metabolomics in cancer research.
Authors: Snyder N.W. , Mesaros C. , Blair I.A. .
Source: Biomarkers in medicine, 2015; 9(9), p. 821-34.
EPub date: 2015-09-01.
PMID: 26329905
Related Citations

What are the main considerations for bioanalysis of estrogens and androgens in plasma and serum samples from postmenopausal women?
Authors: Mesaros C. , Wang Q. , Blair I.A. .
Source: Bioanalysis, 2014; 6(23), p. 3073-5.
PMID: 25529875
Related Citations

Cellular uptake and antiproliferative effects of 11-oxo-eicosatetraenoic acid.
Authors: Snyder N.W. , Revello S.D. , Liu X. , Zhang S. , Blair I.A. .
Source: Journal of lipid research, 2013 Nov; 54(11), p. 3070-7.
EPub date: 2013-08-14.
PMID: 23945567
Related Citations

Modeling of the growth kinetics of occult breast tumors: role in interpretation of studies of prevention and menopausal hormone therapy.
Authors: Santen R.J. , Yue W. , Heitjan D.F. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2012 Jul; 21(7), p. 1038-48.
EPub date: 2012-05-14.
PMID: 22586072
Related Citations

Back to Top