Metabolismo de los estrógenos endógenos y cáncer de mama

  • Francisco Cóppola Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Clínica Ginecotocológica "C", Prof. Adj. Cátedra de Endocrinología, Ex Asistente
  • José Nader Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Clínica Ginecotocológica "C", Docente Honorario. Clínica Ginecotocológica "C", Ex Asistente
  • Rafael Aguirre Universidad de la República, Facultad de Medicina, Centro Hospitalario Pereira Rossell, Clínica Ginecotocológica "C", Docente Honorario. Clínica Ginecotocológica "C", Ex Asistente
Palabras clave: CÁNCER DE MAMA, ESTRÓGENOS, DIETA

Resumen

El cáncer de mama es el cáncer más frecuente en las mujeres de los países desarrollados occidentales. Si bien Uruguay no integra este grupo de países, el cáncer de mama presenta cifras similares a estos, con tasas de incidencia y mortalidad extremadamente altas. La tasa de mortalidad ajustada por edad, en el período de 1993 a 1997, en Uruguay es de 25,1 cada 100.000 mujeres por año, una de las más altas a nivel mundial. Esto ha llevado a que el cáncer de mama sea un grave problema de salud pública en nuestro país.
La relación del cáncer de mama con el uso de hormonoterapia de reemplazo está firmemente establecida. Diversos estudios, en especial el estudio WHI (Women’s Health Initiative), han confirmado el mayor riesgo con el aporte exógeno de estrógenos. Esto, junto a los mayores riesgos cardiovasculares de la terapia estrogénica para los trastornos climatéricos, ha llevado a la drástica reducción de sus indicaciones y uso a nivel mundial.
Sin embargo, el rol de estas hormonas en la patogénesis del cáncer de mama no se reduce a su administración exógena. Los estrógenos endógenos tienen un papel preponderante en la génesis de este cáncer, y distintas situaciones dependientes del ambiente y los hábitos de vida pueden modificar el riesgo de cáncer de mama mediado por estrógenos endógenos. El presente artículo realiza una revisión sobre el metabolismo de los estrógenos y su relación con el cáncer de mama, dado que los distintos metabolitos de los estrógenos tienen acciones biológicas diferentes y una incidencia opuesta en el riesgo de este cáncer. La ruta de metabolización hacia la 2-alfa hydroxyestrona se asocia a una reducción de 40% de desarrollar cáncer de mama. Se analiza la influencia de los cambios dietéticos en la ruta de metabolización de los estrógenos y se plantea la hipótesis de aplicar el cambio de la dieta como una de las estrategias para abatir la incidencia del cáncer de mama.

Citas

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Publicado
2005-03-31
Cómo citar
1.
Cóppola F, Nader J, Aguirre R. Metabolismo de los estrógenos endógenos y cáncer de mama. Rev. Méd. Urug. [Internet]. 31 de marzo de 2005 [citado 21 de mayo de 2022];21(1):15-2. Disponible en: http://revista.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/823
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