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Henrik Falhammar Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

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Magnus Kjellman Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Department of Breast and Endocrine Surgery, Karolinska University Hospital, Stockholm, Sweden

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Jan Calissendorff Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

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Background

With the increasing access to imaging more pheochromocytomas are diagnosed in the workup of adrenal incidentalomas. This may have changed the occurrence of the classic presentation with hypertension and the classic triad (headaches, sweating and palpitation).

Methods

We reviewed 94 consecutive cases of pheochromocytomas. Two cases of ectopic ACTH-syndrome were subsequently excluded.

Results

Of the 92 cases included 64% had presented as an incidentaloma, 32% as a suspected pheochromocytoma and 4% had been screened because of previously diagnosed MEN2A. Those screened were youngest while those with incidentalomas were oldest. The females were more common in the incidentaloma and the screening groups, and males in the suspected pheochromocytoma group. Measurements of noradrenaline/normetanephrine levels were highest in the suspected pheocromocytoma group and lowest in the screening group. Hypertension was present in 63% of the incidentalomas, 79% of suspected pheochromocytomas and in none of the screening group. Paroxysmal symptoms were present in almost all with suspected pheochromocytoma while only in half of the other groups. The suspected pheocromocytoma group had most symptoms and the screening group least. The classic triad was present in 14% of the incidentalomas, in 28% of the suspected and in none of the screening group, while no symptoms at all was present in 12%, 0% and 25%, respectively. Pheochromocytoma crisis occurred in 5%. There was a positive correlation between tumor size vs hormone levels, and catecholamine levels vs blood pressure.

Conclusion

Clinicians need to be aware of the modern presentation of pheochromocytomas since early identification can be life-saving.

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Laszlo Samson Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Ildiko Hircsu Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary

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Monika Katko Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Miklos Bodor Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Annamaria Gazdag Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Andrea Anett Gazso Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary

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Bela Kovacs Institute of Food Science, University of Debrecen, Debrecen, Hungary

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Janos Posta Department of Forensic Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Eszter Balogh Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Peter Mocsary Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Harjit Pal Bhattoa Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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Endre V Nagy Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

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, 14 ). During lactation, iodine is secreted into the milk. Breast milk is the only source of iodine for the breastfed infant, being vital for normal infant thyroid function and thus, for brain development ( 15 ). Mammary glands can concentrate and

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Yusaku Mori Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Department of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Shinagawa, Tokyo, Japan

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Eunhyoung Ko Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

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Rudolf Furrer Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

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Linda C Qu Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

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Stuart C Wiber Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

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I George Fantus Departments of Medicine and Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
Division of Endocrinology and Metabolism, Leadership Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada

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Mario Thevis Center for Preventive Doping Research and Institute of Biochemistry, German Sport University Cologne, Cologne, Germany

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Alan Medline Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada
Department of Pathology, Humber River Regional Hospital, Toronto, Ontario, Canada

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Adria Giacca Departments of Physiology and Medicine, Institute of Medical Science, Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada

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-known metabolic actions ( 1 ). Epidemiological studies showed that, in patients with type 2 diabetes and obese people with insulin resistance, endogenous hyperinsulinaemia is associated with increased risk for several types of cancer including breast cancer ( 2

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Yuan Fang Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, China

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Xuehong Zhang Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

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Huilin Xu Center for Disease Control and Prevention of Minhang District, Shanghai, China

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Stephanie A Smith-Warner Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA

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Dongli Xu Center for Disease Control and Prevention of Minhang District, Shanghai, China

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Hong Fang Center for Disease Control and Prevention of Minhang District, Shanghai, China

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Wang Hong Xu Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, China

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Introduction Type 2 diabetes (T2DM) has been associated with an elevated risk of liver, pancreas, endometrium, colorectal, breast and bladder cancers and a decreased risk of prostate cancer ( 1 , 2 ). Several possible mechanisms have been

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Aida Javanbakht Department of Diabetes, Endocrinology and Metabolism, Beckman Research Institute of City of Hope, Duarte, California, USA

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Massimo D’Apuzzo Department of Pathology, Beckman Research Institute of City of Hope, Duarte, California, USA

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Behnam Badie Department of Neurosurgery, Beckman Research Institute of City of Hope, Duarte, California, USA

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Behrouz Salehian Department of Diabetes, Endocrinology and Metabolism, Beckman Research Institute of City of Hope, Duarte, California, USA

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patient for whom the age was not recorded. There were no pediatric patients with pituitary metastasis. The most common tumors of origins were breast cancer (2 cases) and lymphoma (2 cases). The most common primary clinical presentations were

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Emmanuelle Noirrit Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
Faculté de Chirurgie Dentaire, Université de Toulouse III, Toulouse, France

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Mélissa Buscato Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France

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Marion Dupuis Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France

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Bernard Payrastre Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
CHU de Toulouse, Laboratoire d’Hématologie, Toulouse, France

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Coralie Fontaine Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France

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Jean-François Arnal Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France

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Marie-Cécile Valera Inserm U1048 (I2MC), CHU de Toulouse and Université Toulouse III, I2MC, Toulouse, France
Faculté de Chirurgie Dentaire, Université de Toulouse III, Toulouse, France

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therapy (HRT) has been associated with adverse effects such as an increased incidence of breast cancer and thromboembolic events ( 1 , 2 , 3 ). Venous thromboembolism events (VTEs), which encompasses deep venous thrombosis (DVT) and pulmonary embolism

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Yun Hu Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
Department of Immunology, Nanjing Medical University, Jiangsu, China

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Na Li Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Peng Jiang Department of Thyroid and Breast Surgery, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Liang Cheng Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Bo Ding Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Xiao-Mei Liu Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Ke He Department of Endocrinology, Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangsu, China

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Yun-Qing Zhu Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Bing-li Liu Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Xin Cao Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Hong Zhou Department of Immunology, Nanjing Medical University, Jiangsu, China

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Xiao-Ming Mao Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China

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Objective

Thyroid nodules are usually accompanied by elevated thyroglobulin (Tg) level and autoimmune thyroid diseases (AITDs). However, the relationship between Tg and AITDs is not fully understood. Dysfunction of regulatory T cells (Tregs) plays an important role in the development of AITDs. We aimed to evaluate the effects of Tg on the function of Tregs in patients with thyroid nodules.

Methods

Tg levels and the functions of Tregs in peripheral blood and thyroid tissues of patients with thyroid nodules from Nanjing First Hospital were evaluated. The effects of Tg on the function of Tregs from healthy donors were also assessed in vitro. The function of Tregs was defined as an inhibitory effect of Tregs on the effector T cell (CD4+ CD25 T cell) proliferation rate.

Results

The level of Tg in peripheral blood correlated negatively with the inhibitory function of Tregs (R = 0.398, P = 0.03), and Tregs function declined significantly in the high Tg group (Tg >77 μg/L) compared with the normal Tg group (11.4 ± 3.9% vs 27.5 ± 3.5%, P < 0.05). Compared with peripheral blood, the function of Tregs in thyroid declined significantly (P < 0.01), but the proportion of FOXP3+ Tregs in thyroid increased (P < 0.01). High concentration of Tg (100 μg/mL) inhibited the function of Tregs and downregulated FOXP3, TGF-β and IL-10 mRNA expression in Tregs in vitro.

Conclusions

Elevated Tg level could impair the function of Tregs, which might increase the risk of AITDs in patient with thyroid nodules.

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Enrique Soto-Pedre Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK

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Paul J Newey Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
Department of Endocrinology and Diabetes, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK

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John S Bevan JJR Macleod Centre for Diabetes, Endocrinology and Metabolism (Mac-DEM), Aberdeen Royal Infirmary, University of Aberdeen, Aberdeen, UK

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Graham P Leese Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
Department of Endocrinology and Diabetes, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK

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relationship between prolactin and all-cause cancer or breast cancer have also given inconsistent results ( 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ). Similarly, there are no consistent correlations reported between prolactin levels and bone loss or

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Yee-Ming M Cheung Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia
Department of Endocrinology, Austin Health, Melbourne, Australia
Division of Endocrinology, Diabetes and Metabolism, Northwell, Great Neck, New York, USA

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Rudolf Hoermann Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia

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Karen Van Department of Endocrinology, Austin Health, Melbourne, Australia

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Damian Wu Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia

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Jenny Healy Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia

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Bella Halim Department of Endocrinology, Austin Health, Melbourne, Australia

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Manjri Raval Department of Endocrinology, Austin Health, Melbourne, Australia

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Maria McGill Department of Radiology, Austin Health, Melbourne, Australia

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Ali Al-Fiadh Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia
Department of Cardiology, Austin Health, Melbourne Australia

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Michael Chao Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Australia

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Shane White Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Australia

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Belinda Yeo Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Australia
Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia

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Jeffrey D Zajac Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia
Department of Endocrinology, Austin Health, Melbourne, Australia

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Mathis Grossmann Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia
Department of Endocrinology, Austin Health, Melbourne, Australia

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Introduction In postmenopausal women with early oestrogen receptor-positive (ER+) breast cancer, aromatase inhibitors (AIs) are the mainstay of adjuvant therapy ( 1 ). In this population, AI therapy is directed at the oestrogen axis and

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Jasmin Asberger Department of Obstetrics and Gynecology, Medical Center – University of Freiburg, Freiburg, Germany
Faculty of Medicine, University of Freiburg, Freiburg, Germany

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Thalia Erbes Department of Obstetrics and Gynecology, Medical Center – University of Freiburg, Freiburg, Germany
Faculty of Medicine, University of Freiburg, Freiburg, Germany

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Markus Jaeger Department of Obstetrics and Gynecology, Medical Center – University of Freiburg, Freiburg, Germany
Faculty of Medicine, University of Freiburg, Freiburg, Germany

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Gerta Rücker Institute of Medical Biometry and Statistics, Medical Center – University of Freiburg, Freiburg, Germany

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Claudia Nöthling Department of Obstetrics and Gynecology, Medical Center – University of Freiburg, Freiburg, Germany
Faculty of Medicine, University of Freiburg, Freiburg, Germany

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Andrea Ritter Department of Obstetrics and Gynecology, Medical Center – University of Freiburg, Freiburg, Germany
Faculty of Medicine, University of Freiburg, Freiburg, Germany

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Kai Berner Department of Obstetrics and Gynecology, Medical Center – University of Freiburg, Freiburg, Germany
Faculty of Medicine, University of Freiburg, Freiburg, Germany

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Ingolf Juhasz-Böss Department of Obstetrics and Gynecology, Medical Center – University of Freiburg, Freiburg, Germany
Faculty of Medicine, University of Freiburg, Freiburg, Germany

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Marc Hirschfeld Department of Obstetrics and Gynecology, Medical Center – University of Freiburg, Freiburg, Germany
Faculty of Medicine, University of Freiburg, Freiburg, Germany
Institute of Veterinary Medicine, Georg-August-University Goettingen, Goettingen, Germany

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Introduction With an incidence of 28.2%, breast cancer represents the most common type of cancer in females in Europe ( 1 ). Oestrogen-dependent gene expression regulation is known to play an important role in the promotion and progression of

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