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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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Masatada Watanabe Laboratory of Tissue Regeneration, Hoshi University School of Pharmacy and Pharmaceutical Sciences, Shinagawa, Tokyo, Japan

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Shuji Ohno Division of Research for Pharmacy Students Education, Hoshi University, Shinagawa, Tokyo, Japan

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Hiroshi Wachi Laboratory of Tissue Regeneration, Hoshi University School of Pharmacy and Pharmaceutical Sciences, Shinagawa, Tokyo, Japan

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the face of women aged 52–70 years improved their skin thickness (epidermis + dermis) ( 2 ). Oral application of an estrogen-conjugated tablet in postmenopausal women improved skin elasticity, moisture and thickness ( 3 ). Aromatase inhibitors (e

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Enrique Pedernera Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Embriología y Genética, Ciudad de México, México

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Flavia Morales-Vásquez Instituto Nacional de Cancerología, Ciudad de México, México

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María J Gómora Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Embriología y Genética, Ciudad de México, México

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Miguel A Almaraz Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Embriología y Genética, Ciudad de México, México

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Esteban Mena Universidad Nacional Autónoma de México, Facultad de Medicina, Secretaría General, Ciudad de México, México
Universidad La Salle, Posgrado de la Facultad de Ciencias Químicas, Ciudad de México, México

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Delia Pérez-Montiel Instituto Nacional de Cancerología, Ciudad de México, México

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Elizabeth Rendon Hospital Militar de Especialidades de la Mujer y Neonatología. Ciudad de México, México

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Horacio López-Basave Instituto Nacional de Cancerología, Ciudad de México, México

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Juan Maldonado-Cubas Universidad La Salle, Posgrado de la Facultad de Ciencias Químicas, Ciudad de México, México

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Carmen Méndez Universidad Nacional Autónoma de México, Facultad de Medicina, Departamento de Embriología y Genética, Ciudad de México, México

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at the tissue level ( 5 , 6 , 7 , 8 ). As for ovarian cancer, intratumoral production of steroid hormones has been suggested ( 9 ), while in ovarian carcinoma, the expression of steroid sulfatase ( 10 ), sulfotransferase ( 11 ), aromatase ( 12

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Teresa Vilariño-García Department of Medical Biochemistry, Molecular Biology and Immunology. Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain

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Antonio Pérez-Pérez Department of Medical Biochemistry, Molecular Biology and Immunology. Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain

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Esther Santamaría-López Valencian Infertility Institute (IVI), Seville, Spain

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Nicolás Prados Valencian Infertility Institute (IVI), Seville, Spain

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Manuel Fernández-Sánchez Valencian Infertility Institute (IVI), Seville, Spain

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Víctor Sánchez-Margalet Department of Medical Biochemistry, Molecular Biology and Immunology. Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain

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leptin treatment in GCs from PCOS women ( Fig. 5B ), suggesting that some factors aberrantly expressed in PCOS could be inhibiting the leptin signal transduction pathways. Figure 5 Effect of leptin on aromatase mRNA expression and diminished

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Michael Ulm University of Tennessee Health Science Center, Memphis, Tennessee, USA
West Cancer Center, Memphis, Tennessee, USA

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Arvind V Ramesh White Station High School, Memphis, Tennessee, USA

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Keely M McNamara Tohoku University, Miyagi, Japan

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Suriyan Ponnusamy University of Tennessee Health Science Center, Memphis, Tennessee, USA

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Hironobu Sasano Tohoku University, Miyagi, Japan

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Ramesh Narayanan University of Tennessee Health Science Center, Memphis, Tennessee, USA
West Cancer Center, Memphis, Tennessee, USA

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signaling. Two classes of drugs are available, with one directly antagonizing or degrading the ER in breast cancer cells and the other inhibiting the enzyme aromatase, which is important for the synthesis of estradiol, the primary circulating estrogen, from

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Xi Wang Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China

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Qi Yu Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China

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, and the benefits of current interventions have not been well-established due to the rarity of patients and the heterogeneous nature of the disease. Aromatase inhibitors, which were originally developed for the treatment of oestrogen receptor

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Chan Sub Park Department of Breast and Thyroid Surgery, Kyungpook National University Chilgok Hospital, Buk-gu, Daegu, Republic of Korea

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Jihye Choi Department of General Surgery, National Medical Center, Jung-gu, Seoul, Republic of Korea

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Min-Ki Seong Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Republic of Korea

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Sung-Eun Hong Radiation Medicine Clinical Research Division, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Republic of Korea

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Jae-Sung Kim Radiation Medicine Clinical Research Division, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Republic of Korea

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In-Chul Park Division of Fusion Radiology Research, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Republic of Korea

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Hyesil Seol Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Republic of Korea

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Woo Chul Noh Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Republic of Korea

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Hyun-Ah Kim Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Republic of Korea

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obesity on the prognosis of breast cancer is magnified in menopausal women and those with suppressed ovarian function. Importantly, the prognosis of menopausal patients with breast cancer is affected by obesity; this might arise from elevated aromatase in

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Iben Katinka Greiber Department of Growth and Reproduction, EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Casper P Hagen Department of Growth and Reproduction, EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Alexander Siegfried Busch Department of Growth and Reproduction, EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Mikkel Grunnet Mieritz Department of Growth and Reproduction, EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Lise Aksglæde Department of Growth and Reproduction, EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Katharina Main Department of Growth and Reproduction, EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Kristian Almstrup Department of Growth and Reproduction, EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Anders Juul Department of Growth and Reproduction, EDMaRC, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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-Müllerian hormone produces endocrine sex reversal of fetal ovaries . PNAS 1989 86 3684 – 3688 . ( https://doi.org/10.1073/pnas.86.10.3684 ) 17 Grossman MP Nakajima ST Fallat ME Siow Y. Müllerian-inhibiting substance inhibits cytochrome p450 aromatase

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Martin Zweifel Department of Medical Oncology, University Hospital Bern, Bern, Switzerland

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Beat Thürlimann Breast Centre St. Gallen, Kantonsspital St. Gallen, St. Gallen, Switzerland

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Salome Riniker Breast Centre St. Gallen, Kantonsspital St. Gallen, St. Gallen, Switzerland

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Patrik Weder Breast Centre St. Gallen, Kantonsspital St. Gallen, St. Gallen, Switzerland

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Roger von Moos Kantonsspital Graubünden, Chur, Switzerland

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Olivia Pagani Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland

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Martin Bigler SAKK Coordinating Centre, Bern, Switzerland

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Karin M Rothgiesser SAKK Coordinating Centre, Bern, Switzerland

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Christiane Pilop SAKK Coordinating Centre, Bern, Switzerland

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Hanne Hawle SAKK Coordinating Centre, Bern, Switzerland

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Peter Brauchli SAKK Coordinating Centre, Bern, Switzerland

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Coya Tapia Institute of Pathology, University of Bern, Bern, Switzerland

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Wolfgang Schoenfeld CURADIS GmbH, Erlangen, Germany

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Cristiana Sessa Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland

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for the Swiss Group for Clinical Cancer Research (SAKK)
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androgen receptor (AR) modulators (SARMs) rather than testosterone may be used to treat AR-positive BC. CR1447 (4-hydroxytestosterone (4-OHT)) is a steroidal small molecule with two distinct properties, acting as a steroidal aromatase inhibitor (AI) and

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Kristin Ottarsdottir Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Anna G Nilsson Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Margareta Hellgren Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Ulf Lindblad Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Bledar Daka Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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cytokines, leptin, estradiol and insulin. These substances may inhibit the activity of the hypothalamic–pituitary gonadal axis at multiple levels, thus lowering the concentrations of testosterone ( 7 ). There is also evidence that obesity increases aromatase

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