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Effect of Breast Surgery on Serum Levels of Insulin-Like Growth Factors (IGF-I, IGF-II, and IGF Binding Protein-3) in Women With Benign and Malignant Breast Lesions

From the Department of Endocrinology (IMH, AEL, BHM, VS), School of Medicine, Auckland University; St. Mark’s Breast Centre (JEH); and Department of Surgery (MM, IDC), Auckland Hospital, Auckland, New Zealand.

Correspondence: Address correspondence and reprint requests to: Professor I. M. Holdaway, Department of Endocrinology, Auckland Hospital, Park Rd, Auckland, New Zealand; Fax: 64-9-307-4993.

BACKGROUND: There is evidence that insulin-like growth factors play a role in the development of breast cancer. Antiestrogens reduce circulating levels of IGF-I, but the influence of other breast cancer treatments, including surgery, is unknown and is investigated in this study.

METHODS: Circulating serum concentrations of IGF-I, IGF-II, and IGF binding protein-3 (IGFBP-3) were measured before and after breast surgery in 31 patients with breast cancer and 12 controls with benign breast lesions. Serum albumin was measured as a marker of the nonspecific metabolic effect of surgery.

RESULTS: Serum IGF-I, IGF-II, IGFBP-3, and albumin fell 24 hours after surgery for breast cancer but largely normalized again over the next 7 days. The fall in IGF-I and IGFBP-3 was not significant when the change in serum albumin was used as a covariate, suggesting a nonspecific effect of surgery. However, the reduction in IGF-II remained significant when adjusted for albumin and was greater after lumpectomy of malignant tumors (-8 ± 2%) compared with benign disease (2 ± 2%, P = .001). The fall in IGF-II was significantly related to the size of the removed tumor.

CONCLUSIONS: Breast cancer may directly influence the serum concentration of IGF-II, possibly by direct tumor production.

Key Words: Breast neoplasms— • Breast dysplasia— • Surgery— • IGF-I— • IGF-II— • IGFBP-3.

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