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Measurement of Serum Estradiol
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To the Editor: Dr Cummings and colleagues1 found that serum estradiol levels may be useful to identify women who would be most likely to benefit from prophylactic use of raloxifene to prevent breast cancer. Application of their results, however, which used a "sensitive" assay, may not be directly applicable to the commercially available assays for serum estradiol that are generally used in clinical practice. The apparent average value for estradiol in their population of postmenopausal women using this assay was 2.93 pg/mL, which is much lower than the range of 10 to 20 pg/mL used in daily clinical practice.2 Thus, their results must be adjusted before they can be applied to clinical practice.
AUTHOR INFORMATION
This letter was shown to Dr Cummings and colleagues, who declined to reply. —ED.
Fergus McKiernan, MD;
Carmen Wiley, PhD
Center for Bone Diseases
Marshfield Clinic
Marshfield, Wis
1. Cummings SR, Duong T, Kenyon E, Cauley JA, Whitehead M, Krueger KA. Serum estradiol level and the risk of breast cancer during treatment with raloxifene. JAMA. 2002;287:216-220.
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2. Speoff L, ed, Glass RH, ed, Kase NG, ed. Clinical Gynecologic Endocrinology and Infertility. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1999:658.
Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.
JAMA. 2002;287:1528.
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RELATED ARTICLE
Serum Estradiol Level and Risk of Breast Cancer During Treatment With Raloxifene
Steven R. Cummings, Tu Duong, Emily Kenyon, Jane A. Cauley, Malcolm Whitehead, Kathryn A. Krueger, and for the Multiple Outcomes of Raloxifene Evaluation Trial
JAMA. 2002;287(2):216-220.
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