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Summary: Epidemiological studies demonstrated that, in postmenopausal women, high circulating levels of testosterone, especially when associated with weight gain, positively correlated with an increased risk of breast cancer because of the augmented production of oestrogen via testosterone aromatization in the adipose tissue. Besides, growing evidence suggests that sulfatase can increase the tissue concentration of bioactive estradiol through the reconversion of estrone sulfate, thus providing a favourable milieu for epithelial cells expressing the oestrogen receptor. In this review, we will discuss how the "obesity‐insulin‐testosterone" connection and the abnormal production of bioactive oestrogen ‐ as a result of the conversion of the androgens by aromatase and the estrone reconversion by sulfatase−, may affect the response to hormone therapy and the outcome of postmenopausal breast cancer patients, and how a combined therapy including metformin, anti‐inflammatory drugs, and aromatase/sulfatase inhibitors could successfully improve patient's outcome. [ABSTRACT FROM AUTHOR]

( Cancer Sci 2010; 101: 826–830) The purpose was to ascertain whether the recurrence risk patterns for patients with estrogen receptor (ER)-positive (P) and ER-negative (N) breast cancer support the ER-related clinical divergence suggested by the observed different mortality patterns and gene expression profiles. Both recurrence and death were considered in a series of 771 patients undergoing mastectomy. ER status was available for 539 patients. The hazard rates for recurrence and mortality throughout 15 years of follow-up were assessed. The recurrence dynamics displays a bimodal pattern for both ERP and ERN tumors with comparable peak timings. The two curves cross during the 3rd year. By contrast, the mortality dynamics are definitely different for ERP and ERN tumors: during the early follow-up period ERN patients have their highest mortality risk, while ERP patients have their lowest mortality risk. The two curves cross during the 5th year. In spite of the different mortality dynamics, the recurrence dynamics do not demonstrate a major distinction in timing between ERP and ERN breast cancers, suggesting that the metastasis development process following mastectomy is apparently similar for both ER categories. The observed differences in the mortality risk are plausibly attributable to ER-related factors influencing the clinical course from recurrence to death. These clinical findings apparently contradict the occurrence of two different types of breast cancer, notwithstanding the distinct epidemiological, clinical, and molecular features linked to ERP and ERN tumors, although ER levels may concur to establish the event risk levels. [ABSTRACT FROM AUTHOR]

The article focuses on a study which investigated the outcome of conservative surgery and tamoxifen on elderly breast cancer patients. The study included 354 breast cancer patients who were diagnosed with operable breast cancer and no palpable axillary lymph nodes and underwent conservative surgery and adjuvant tamoxifen, without axillary dissection and postoperative radiotherapy. The study concluded that conservative surgery is safe for patients diagnosed with early breast cancer and no palpable axillary lymph nodes.