Title: “Low Salivary Testosterone Levels in Patients with Breast Cancer” Authors:

Introduction: Correlation between circulating sex steroid levels and breast cancer has been controversial, with measurement of free, or bioavailable hormone rarely available. Salivary hormone levels represent the bioavailable fraction. We aimed to assess correlation between salivary sex steroid levels and breast cancer prevalence. Methods: Salivary hormone levels of testosterone (T), Estradiol (E2), Progesterone (P), Estriol (E3), Estrone (E1), DHEAS and Cortisol (C) were measured by Enzyme Immunoassay (EIA) in 357 women with histologically verified breast cancer and 184 age-matched control women. Results: Salivary T and DHEAS levels were significantly lower in breast cancer cases vs controls (27.2+13.9 vs 32.2+17.5 pg/ml, p<0.001 for T and 5.3+4.3 vs 6.4+4.5 ng/ml, p=0.007 for DHEAS). E2 and E1 levels were elevated and E3 levels were lowered in cases vs. controls. Conclusions: Salivary T levels representing bioavailable hormone are significantly lower in women with breast cancer compared to age-matched control women. Key terms: saliva, testosterone, androgens, breast cancer