Preconception prevention of lactation disorders in women with fibrocystic breast disease

Authors

DOI:

https://doi.org/10.18370/2309-4117.2021.58.97-100

Keywords:

fibrocystic breast disease, preconception, lactation

Abstract

Study objective: to establish the clinical efficacy of 1.0% micronized progesterone gel Progestogel® at the preconception stage in order to prevent lactation disorders in women with fibrocystic breast disease (FBD).
Materials and methods. The main group consisted of 30 women with diffuse forms of FBD who applied on each mammary gland 2.5 g 1.0% micronized progesterone gel Progestogel® for 6 months daily at the stage of pregnancy planning. The comparison group included 30 women with diffuse forms of FBD who did not use Progestogel® at the stage of pregnancy planning. The control group consisted of 30 healthy pregnant women without pathological changes in mammary glands. Stages of observation included preconception period, pregnancy, postpartum period, lactation period and long-term period (6 month after the end of lactation).
Results. Preconception preparation with transdermal 1.0% micronized progesterone gel Progestogel® in patients with diffuse forms of FBD promoted long-term breastfeeding and a regressive course of the breast pathological process. Examination of this group of patients in the long-term period (6 month after the end of lactation) showed no clinical manifestations of the breast disease (pain syndrome and edema) in 24 (80.0%) women and regression of ultrasound signs of FBD in 21 (70.0%) patients. Manifestation of both clinical and echographic signs of the breast disease was diagnosed in 26 (86.7%) women in the comparison group. Transdermal 1.0% micronized progesterone gel in the preconception preparation associated with no complications of the early lactation period in 83.3% of patients and provided a long (12 months) lactation process in 66.7% of patients.
Conclusion. Progestogel® is an effective pathogenically substantiated means of safe therapy for diffuse forms of FBD. The protective effect of 1.0% micronized progesterone gel Progestogel® associated with regression of clinical and echographic manifestations of FBD in 80.0% of women.

Author Biographies

S.I. Zhuk, Shupyk National Healthcare University of Ukraine

MD, professor, head of Obstetrics, Gynecology and Fetal Medicine Department

V.K. Kondratiuk, Shupyk National Healthcare University of Ukraine

MD, professor, Obstetrics, Gynecology and Fetal Medicine Department

K.O. Kondratiuk, O.O. Bogomolets National Medical University

PhD, associate professor, Department of Endocrinology

References

  1. Ovsyannikova, T.V. «The program of examination and treatment of patients with diseases of the mammary glands in the practice of an obstetrician-gynecologist.” Gynecology 19.1 (2017): 37–41.
  2. Holanda, A.A.R., Gonçalves, A.K.S., Medeiros, R.D., et al. “Ultrasound findings of the physiological changes and most common breast diseases during pregnancy and lactation.” Radiol Bras 49 (2016): 389–96. DOI: 10.1590/0100-3984.2015.0076
  3. Heba Elsedfy. “A clinical approach to benign breast lesions in female adolescents.” Acta Biomed 88.2 (2017): 214–21. DOI: 10.23750/abm.v88i2.6666
  4. Radzinskiy, V.E., ed. Mammary glands and gynecological diseases. Moscow. Status Praesens (2012).
  5. Bespalov, V.G., Travina, M.L. “Fibrocystic disease and the risk of breast cancer (literature review).” Tumors of the female reproductive system 4.11 (2015): 58–70. DOI: 10.17650/1994-4098-2015-11-4-50-70
  6. Stachs, A., Stubert, J., Reimer, T., Hartmann, S. “Benign Breast Disease in Women.” Dtsch Arztebl Int 116.33–34 (2019): 565–74. DOI: 10.3238/arztebl.2019.0565
  7. Dekkers, O.M., Ehrenstein, V., Bengtsen, M., et al. “Breast cancer risk in hyperprolactinemia: a population-based cohort study and meta-analysis of the literature.” Eur J Endocrinol 173.2 (2015): 269–73. DOI: 10.1530/EJE-15-0282
  8. Kerchelaeva, S.B., Smetnik, A.A., Bespalov, V.G. “Mastopathy and prevention of breast cancer as an interdisciplinary problem.” Russian Medical Journal 15 (2016): 1018–25.
  9. Linton, L., Taylor, M., Dunn, S., et al. “Associations of serum levels of sex hormones in follicular and luteal phases of the menstrual cycle with breast tissue characteristics in young women.” PLoS One 11.10 (2016): e0163865.
  10. Savelyeva, G.M., Sukhikh, G.T., Serova, V.N., et al; eds. Gynecology: National Guideline. Moscow. GEOTAR-Media (2019): 1008 p.
  11. Rozhkova, N.I., Sotnikov, A.A., Sotnikova, L.S., et al. The mammary gland. Must not be ignored. Benign breast dysplasia: modern concepts. Moscow. Editorial board of Status Praesens Journal (2019): 16 p.
  12. Rhonda Arthur, Yihong Wang, Kenny Ye. “Association between lifestyle, menstrual/reproductive history, and histological factors and risk of breast cancer in women biopsied for benign breast disease.” Breast Cancer Res Treat 165.3 (2017): 623–31.
  13. Figueroa, J.D., et al. “Risk factors for breast cancer development by tumor characteristics among women with benign breast disease.” Breast Cancer Res 23 (2021): 34.
  14. Figueroa, J.D., Pfeiffer, R.M., Brinton, L.A., Palakal, M. “Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease.” Breast Cancer Res Treat 159.1 (2016): 163–72.
  15. Muctafin, C.N. “Hormonal regulation of mammary glands and premenstrual syndrome.” Lechaschiy vrach 3 (2018): 44–9.
  16. Lee, A., Mavaddat, N., Wilcox, A.N., Cunningham, A.P. “А comprehensive breast cancer risk prediction model incorporating genetic and nongenetic risk factors.” Genet Med 21.8 (2019: 1708–18.
  17. Roman, M., Quintana, M.J., Ferrer, J., et al. “Cumulative risk of breast cancer screening outcomes according to the presence of previous benign breast disease and family history of breast cancer: supporting personalised screening.” Br J Cancer 116.11 (2017): 1480–5.
  18. Rodionov, V.V., Smetnik, A.A. “Benign diseases of the mammary glands.” Obstetrics and gynecology: News. Opinions. Training 1/19 (2018): 90–100.
  19. Ministry of Health of Russian Federation. Benign Breast Dysplasia: Clinical Practice Guidelines (2018).
  20. Kornatskaya A.G., Dubenko O.D. “Benign diseases of the mammary glands in the practice of obstetrician-gynecologist.” Women's health 2 (2012): 9–20.
  21. Radzinsky, V.Y., Ordiyants, I.M., Maslennikova, M.N., et al. Mammary glands and gynecological diseases: from common pathogenetic views to practical solutions. Opportunities for improving the health of women with a combination of uterine fibroids and benign dysplasia of the mammary glands. Moscow. Editorial board of StatusPraesens Journal (2012): 16 p.
  22. Myasnyankin, M.u., Anisimov, V.V. “Experience in treating breast pathology in outpatient practice.” Ambulatornaya khirurgiya 1–2 (2020): 95–102.
  23. Fatemeh Salamat, Babak Niakan, Abbasali Keshtkar, Elahe Rafiei. “Subtypes of Benign Breast Disease as a Risk Factor of Breast Cancer: A Systematic Review and Meta Analyses.” Iran J Med Sci 43.4 (2018): 355–64.
  24. Anstey, E.H., Shoemaker, M.L., Barrera, C.M. “Breastfeeding and Breast Cancer Risk Reduction: Implications for Black Mothers.” Am J Prev Med 53.3 Suppl 1 (2017): S40–S46.
  25. Brouckaert, O., Rudolph, A., Laenen, A. “Reproductive profiles and risk of breast cancer subtypes: a multi-center case-only study.” Breast Cancer Res 19 (2017): 119.
  26. Zhabchenko, I.A., Khominskaya, Z.B., Shekera, I.O., et al. “The state of lactogenesis and lactopoiesis in women with fibrocystic breast disease.” Materials of XIV Congress of the World Federation of Ukrainian medical societies, Donetsk, October 04-06, 2012. National Medical University named after Maxim Gorky. Donetsk (2012): 84–5.
  27. Kosei, N.V. “Correction of hormonal imbalance in patients with diffuse forms of mastopathy is the basis of pathogenetic therapy and prevention.” Reproductive endocrinology 3 (2018): 8–14.
  28. Nutter, E.L., Weiss, J.E. “Personal History of Proliferative Breast Disease with Atypia and Risk of Multifocal Breast Cancer.” Cancer 124.7 (2018): 1350–7.
  29. Daly, A.A., Rolph, R., Cutress, R.I., Copson, E.R. “A Review of Modifiable Risk Factors in Young Women for the Prevention of Breast Cancer.” Dove Med Press 13 (2021): 241–57.
  30. Babaeva, N.A., Ashrafyan, L.A., Antonova, I.B., et al. “The role of hormonal disorders in the carcinogenesis of tumors of the female reproductive system.” Obstetrics and gynecology: news, opinions, training 1 (2017): 76–82.
  31. T.E. Ermolenko, T.L. Prutiian. “Mastopathy is a biomarker of hormonal disruption.” Reproductive Endocrinology 3.53 (2020): 2–6.
  32. Radzinskiy, V.E., ed. Breast medicine and gynecological diseases. 2nd edition. Moscow. Editorial board Status Praesens Journal (2017): 352 p.
  33. Tatarchuk, T.F., Yefimenko, O.A. “Hyperprolactinemia as a cause of benign breast diseases.” Medical aspects of women's health 5.91 (2015).
  34. Pavlova, E.A., Arakelov, S.E., Ordiyants, I.M., et al. “Modern views on benign breast dysplasias and their relationship with gynecological diseases.” Vestnik RUDN. Medicine. Obstetrics and gynecology 5 (2012): 487–93.
  35. Brkic, M., et al. “The Influence of Progesterone Gel Therapy in the Treatment of Fibrocystic Breast Disease.“ Open Journal of Obstetrics and Gynecology 6 (2016): 334–41.
  36. Dyrstad, S.W., et al. “Breast cancer risk associated with benign breast disease: systematic review and meta-analysis.” Breast Cancer Res Treat 149.3 (2015): 569–75.
  37. Tumanova, L.E., Kolomiets, A.V., Badzyuk, N.P. “The state of the mammary glands during pregnancy and lactation function in women with a large intergenetic interval.” Perinatology and pediatric. Ukraine 2.74 (2018): 26–30.

Published

2021-05-27

How to Cite

Zhuk, S., Kondratiuk, V., & Kondratiuk, K. (2021). Preconception prevention of lactation disorders in women with fibrocystic breast disease. REPRODUCTIVE ENDOCRINOLOGY, (58), 97–100. https://doi.org/10.18370/2309-4117.2021.58.97-100

Issue

Section

Tumors and pretumoral pathology