Exogenous Hormone Use and Breslow Thickness in Women With Cutaneous Melanoma: A Retrospective Cohort Study

Cutaneous melanoma remains a major public health issue with increasing incidence among fair-skinned populations. Beyond well-established risk factors such as ultraviolet exposure, there is evidence suggesting female sex hormone influence in melanoma biology and prognosis. Although several epidemiological studies have explored the relationship between exogenous hormones and melanoma risk, findings remain inconsistent. This study aims to investigate the association between exogenous hormonal use and Breslow thickness assessing differences across female life stages.

A retrospective study of 464 female patients with histologically confirmed primary superficial spreading melanoma (SSM) diagnosed from 2010 to 2021 in Andreas Sygros Hospital of Cutaneous and Venereal Diseases was conducted. Multiple linear regression models were performed to examine the association of hormonal use and thickness among females of different age groups (< 45, 45-59, and ≥ 60 years).

Significant inverse associations between hormone use and Breslow thickness were found for women aged 45-59 years, with oral contraceptive (OC) use being associated with a 30% reduction in thickness (95% confidence interval [CI]: -47.9, -6.4) when considering all confounders. Exposure to any exogenous hormone was found to be positively associated (percent of change [PC]: 25.6, 95% CI: -7.2, 70.1) with tumor thickness among women above 60 years, indicating an effect modified by age. No significant associations were observed in females under 45 years.

These results indicate that the effect of exogenous hormone use on tumor thickness may be age-related, with an inverse association observed during the peri-menopausal period, and a positive relationship found among females above 60 years. Future research is needed to explore estrogen-mediated mechanisms influencing melanoma prognosis.