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    Until recently it never occurred to me that PSA is also present in women. A patient couple came to see me and they wanted the periodic blood check-up to be done. They had the results of the last year check-up and I asked them to repeat the same for both of them. Suddenly I recollected that he was a patient of BPH and I called him back and wrote for a PSA test. Before he took leave of me, he asked me whether this test was for both of them. Vehemently denying I told him it was for him only. That incident spurred my mind and I wanted to know whether at all this man’s query was a relevant one. What I got from Google search is really revealing. The following are some of the facts I collected:
    It was believed that PSA was produced exclusively by the epithelial cells of the prostate gland, but a large body of evidence demonstrates that PSA is not a prostate-specific molecule. PSA has been shown to be expressed in many forms of female tissues. The breast is a major female organ able to produce PSA. PSA is detected in both normal and abnormal breast tissues, as well as in various breast fluids including milk, nipple aspirate, and cyst fluid. Androgens and progesterones, via their receptors, regulate the production of PSA in breast tissue. Clinical studies demonstrate that PSA in breast cancer is associated with the expression of estrogen receptor and progesterone receptor. Women with PSA-positive breast cancer have better disease-free survival as well as overall survival than those with PSA-negative breast cancer. PSA levels in nipple aspirate fluid may be indicative of breast cancer risk. High concentrations of PSA are found in amniotic fluid and the levels change with gestational age. Pregnant women have elevated serum PSA. PSA levels in serum also vary during menstrual cycles and increase in women with excess androgen. Clinical implications of PSA in amniotic fluid and female serum have been suggested. More studies are needed to further explore their utilities. (https://www.ncbi.nlm.nih.gov/pubmed/10234897)
    Blood samples of 55 women with breast cancer were prospectively analyzed for PSA before and after breast surgery, with a control group of 82 healthy women.
    Total and free PSA levels were significantly higher in women with breast cancer (preoperatively) than in healthy women (P<0.001). Both serum TPSA and FPSA showed a significant decline in their pre-surgical values after surgical removal of the tumor (P<0.001). A significant proportion of breast cancer patients (83.6%) had free PSA as the predominant molecular form in serum as compared to 0% of controls and 1.8% of postoperative groups (P<0.001). TPSA and FPSA levels were significantly associated with younger age and earlier cancer stage, whereas no significant association was found between these two variables and FPSA as a predominant molecular form. (https://www.ncbi.nlm.nih.gov/pubmed/23932967
    https://www.ncbi.nlm.nih.gov/pubmed/20973208 )

    UA Mohammed

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