Cell line experiments have confirmed the role of aromatase in stimulating the growth of breast cancer cells (24, 59, 60, 61). Additionally, aromatase overexpression has been reported to be associated with a poor clinical outcome in women with breast cancer (62) (Figure 2). Such a relationship was not seen with the clinicopathological parameters of other tumour characteristics. The lack of correlation between aromatase expression and these clinicopathological factors including age, tumour size, axillary lymph node involvement, grade, and histological type was previously reported (63, 64, 65).
Interestingly, Brodie et al. (66) found that tumours with a relatively high aromatase activity tended to be ER-positive. Miller et al. (63) also observed a significant trend towards an association between aromatase activity and the presence of ERa, alt ugh tumours expressing active aromatase included both ERa positive and negative tumours.
The increasing evidence that aromatase inhibitors are superior to tamoxifen in postmenopausal women with ER positive early and advanced breast cancer is in keeping with our observation that higher aromatase expression correlates with poor clinical outcome (67, 68, 69).
Figure 2. Kaplan-Meier analysis of disease-free survival of breast cancer patients depending on the expression of Aromatase mRNA (P = 0.0105). (0 = Low levels; 1.00 = High levels (cut-off point: 10 000)).
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