Lack of evidence that progesterone in ovulatory cycles causes breast cancer
Document Type
Journal Article
Publication Date
12-1-2023
Journal
Climacteric : the journal of the International Menopause Society
Volume
26
Issue
6
DOI
10.1080/13697137.2023.2249813
Keywords
Progesterone; RANKL; breast cancer; estradiol; menopause treatment; ovulation; pregnancy
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.
APA Citation
Gompel, A; Seifert-Klauss, V; Simon, J A.; and Prior, J C., "Lack of evidence that progesterone in ovulatory cycles causes breast cancer" (2023). GW Authored Works. Paper 4084.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4084
Department
Obstetrics and Gynecology