PCOS Question - Increased Risk Breast Cancer?

[John146]

Accoring to FA for Step II CK (p. 374) PCOS is associated with an increased long-term risk for endometrial AND breast cancer.

I encountered 2 questions in USMLE World Q-bank that state PCOS is NOT associated with an increase in breast cancer (although it is associated with an increased risk for endometrial cancer).

Any thoughts? Increased risk for endometrial cancer ALONE, or breast cancer too?

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[Golding]

Studies disagree on the subject, and whenever that happens I think you should err on the side of "No" until research really proves it otherwise. PCOS and Endometrial Cancer have a much more established relationship, with the mechanism being reasonably well understood. So if you're caught deciding between PCOS leading to Endometrial cancer or Breast cancer, Endometrial is your safest bet.

 

[Fuzuli]

http://www.ncbi.nlm.nih.gov/pubmed/16019362

"Polycystic ovary syndrome [PCOS] is the most common endocrinopathy of women in reproductive age. An association between PCOS and type-1 endometrial cancer has often been reported in the literature. The prolonged anovulation with consequent continued secretion of estrogen unopposed by progesterone may enhance the development and growth of this malignancy, particularly in young women. Hypersecretion of luteinizing hormone [LH], chronic hyperinsulinemia and increased serum insulin-like growth factor [IGF]-I levels may represent risk factors for endometrial cancer. However, data available in the literature do not allow a meta-analysis to be carried out to calculate an estimate of the relative risk of endometrial cancer in women with PCOS. Anecdotal cases of low-grade endometrial stromal sarcoma and carcinosarcoma have been reported in association with prolonged unopposed estrogen stimulation, and in particular with PCOS. A few studies have addressed the possibility of an association between PCOS and epithelial ovarian cancer risk, and the results are conflicting but generally reassuring, and similarly the few available data appear to exclude a strong association between PCOS and breast cancer."

 

[John146]

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