Steroid and cation correlations in human breast cyst fluid: preliminary findings

Gross cystic disease (GCD) of the breast imparts a minimal risk for the development of breast cancer. Relative to serum, breast cyst fluid (BCF) in patients with GCD is highly concentrated in androgens, estrogens, certain enzymes, and bioactive polypeptides. In addition, the cations, sodium and potassium, vary markedly and inversely in BCF. We have focused on the levels of estriol-3-sulfate (E3S), which are several orders of magnitude greater in BCF than in blood. In this preliminary study, about 55 specimens of BCF were analyzed for E3S, its possible precursors, estrone sulfate (E1S) and dehydroisoandrosterone sulfate (DHAS), and the cations, sodium and potassium. The data were analyzed statistically by linear regression analysis. E3S correlated directly with both E1S and DHAS (p less than 0.002), and inversely with the Na/K ratio (p less than 0.003). Low Na/K ratio has been associated with secretory processes in cyst epithelium. The data suggest that E3S may originate via 16 alpha-hydroxylation of estrogen in the cyst and that elevated E3S levels may be indicative of a secretory epithelium. This is part of an ongoing prospective study involving 400 subjects with GCD to see whether hormonal and enzymic profiles can be related to cancer risk.