Estrogen Metabolism and Breast Cancer

Some metabolites (break-down products) of estrogen increase the risk of breast cancer, whereas others protect against breast cancer. Estrogen can be metabolised (broken down) in your body into one or more of the following metabolites:

  • 2-hydroxyestrone / 2-hydroxyestradiol (2-OHE)
  • 4-hydroxyestrone / 4-hydroxyestradiol (4-OHE2)
  • 16α-hydroxyestrone (16α-OHE1)

2-OHE has very weak estrogenic activity and is actually protective against breast cancer, whereas 4-OHE and 16α-OHE1 both have full estrogenic activity and turn on the estrogen receptor that is involved in breast cancer (estrogen receptor alpha). Both 4-OHE and 16α-OHE1 increase the risk for breast cancer.

A urine test that measures the ratio between the 2-OH and 16-OH estrogen metabolites can be ordered to assess whether your body is making more of the protective or harmful type of estrogen metabolite. Lifestyle and dietary changes can be prescribed based on the findings and the test repeated to assess the impact of specific lifestyle and dietary changes on the ratio.

The test is available through Dr Cornelia Botha. To make an appointment with Dr Botha please visit our contact page.


Further testing related to breast cancer and estrogen metabolism

Genetic tests related to estrogen metabolism and breast cancer

The DNA Oestrogen genetic test includes 10 single nucleotide polymorphisms (SNPs) involved in the production and metabolism of oestrogen, as well as the antioxidant, detoxification and methylation genes responsible for protecting against breast cancer. Research has shown that the risks associated with these SNPs are modifiable by individualised diet and lifestyle changes, as well as specific supplements.

R2500.00 (includes a follow-up consultation to discuss the results of the testing).

Genetic testing for BRCA 1 and BRCA is also available. This type of test assesses the genetic susceptibility for breast and ovarian cancer within families.

The DNA Oestrogen test is available through Dr Cornelia Botha. To make an appointment with Dr Botha please visit our contact page.


To make an appointment with either Dr Cornelia Botha or Dr Tanith Davidson please visit our contact page.