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

Ian M. Holdaway MD, FRACP, Anne E. Lethaby MA, Barbara H. Mason BSc, Vijay Singh BSc, John E. Harman MBChB, FRACS, Murray MacCormick MBChB, FRACS, Ian D. Civil MBChB, FRACS
Original Article
Volume 8, Issue 1 / January ,

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Abstract

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.

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