The Role of E2/P Ratio in the Etiology of Fibrocystic Breast Disease, Mastalgia and Mastodynia

Brkic, Milena; Vujovic, Svetlana; Ivović, Miomira; Tancic-Gajic, Milina; Marina, Ljiljana; Ivanisevic, Maja; Franić, Damir

doi:10.20471/acc.2018.57.04.18

Cited by 9 publications

(9 citation statements)

References 21 publications

(24 reference statements)

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“…In this study, the predominant imaging diagnosis was fibroadenoma in those with lesions (Figure 1), followed by solitary or multiple simple breast cyst(s) (Figure 2), fibrocystic disease (Figure 3), lactating/nonlactating breast abscesses (Figures 4A and B), and cancer (Figure 5). This finding is in a similar vein with some studies (12,16) and in contrast with some other studies claiming a fibrocystic change as the most common breast pathology in women with breast pain (1,2,29,31,32). Interestingly, we observed just one case with a sonological diagnosis of diffuse mastitis, which we assumed was tuberculous, but ended up with a histological diagnosis of breast myxoedema (Figure 6).…”

Section: Discussionsupporting

confidence: 92%

Concerns About Breast Pain: How Useful Is Imaging?

2022

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Background: Breast pain is one of the most common reasons for referral to breast imaging. Objectives: This study aimed to determine the diagnostic yield of mammography and sonomammography in women complaining of breast pain in a teaching hospital in Southeast Nigeria. Methods: This descriptive study analyzed the mammographic/sonomammographic images and records of 241 consecutive adult women aged 18 - 81 years with breast pain who presented to the radiology department over three years. A non-random sampling method was employed to select the participants. The extracted variables were patient’s age, positive clinical history of breast pain, laterality of breast pain, type of imaging, presence or absence of lesion, type, and laterality of lesions if present, and Breast Imaging Reporting and Data System (BI-RADS) assignment of imaging findings on mammography and sonomammography. The descriptive analysis of continuous variables and inferential statistics of ordinal data were performed with Microsoft Excel and chi-squared test, respectively. In this study, P < 0.05 was set as the significance level. Results: Most women (20%) with a complaint of breast pain were in the 40 - 44-year age group. Moreover, 32.3%, 33.2%, and 34.4% of the participants had left-sided, right-sided, and bilateral breast pain, respectively. Among the participants, 118 and 123 women had mammography and sonomammography, respectively. Furthermore, 76.3% had normal findings on mammography or sonomammography, and only 23.7% had positive imaging findings on breast imaging. These lesions were mostly observed among the women in the age group of 45 - 49 years. Of those with lesions detected on imaging, 79.2% and 20.8% demonstrated benign and malignant attributes, respectively. Masses with definite benign attributes assigned BI-RADS II were mostly fibroadenomata and cysts. Inferential statistics indicated that unilateral mastalgia was more likely to be associated with a breast lesion, while bilateral mastalgia usually resulted in normal breast imaging findings. Conclusions: Women referring to the Radiology Department with a complaint of breast pain alone are unlikely to have any significant breast imaging finding; hence, imaging serves as a tool for assuaging the anxiety of these patients and reassuring the referring physician. Unilateral but not bilateral mastalgia is likely to yield positive imaging findings, which are largely benign.

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Section: Discussionsupporting

confidence: 92%

Concerns About Breast Pain: How Useful Is Imaging?

2022

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“…It is a hormonedependent disease with lobular and diffuse increases in glandular tissue [10,11]. Small cysts, large cysts, and diffuse micronodules may be seen, and pain, tension, and tender nodes in the breast are the most common complaints in women with FBD [12].…”

Section: Discussionmentioning

confidence: 99%

The association of fibrocystic breast disease with endometrial histopathological results in abnormal uterine bleeding

et al. 2022

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Background/Aim: Fibrocystic breast disease (FBD) is the most frequent benign breast disease. Increased estrogen and decreased progesterone concentrations are thought to be involved in the pathogenesis of FBD. But there is insufficient data on benign breast disease and endometrial pathology. This study evaluates the association between FBD and endometrial pathology in women complaining of abnormal uterine bleeding. Methods: This study was designed as a retrospective case-control study. The medical records of women who had endometrial sampling for abnormal uterine bleeding between 2018 and 2020 were evaluated. Patients with FBD were included in the study group, while the first patients who had endometrial sampling after patients with FBD and without breast disease were recruited as the control group. Demographic, laboratory data, and endometrial histopathological results were obtained from hospital records and compared between the groups. Results: In total, 250 women (106 women with FBD and 144 without breast disease) were recruited for the study. There was no statistically significant difference in mean age, gravidity, parity, and BMI between FBD and control groups. Endometrial hyperplasia without atypia (19.8% versus 10.5%, respectively, P = 0.037) and endometrial polyp (12.2% versus 4.8%, respectively, P = 0.033) were found to be significantly increased in patients with FBD than women without the disease. There was no statistically significant difference in terms of other histopathological results between the groups. Conclusion: Evaluation of the endometrium for abnormal uterine bleeding is essential for early diagnosis and treatment of endometrial pathology, especially for endometrial cancer. In this study, we found that women with FBD have an increased risk for endometrial hyperplasia and endometrial polyp. As endometrial hyperplasia is a precursor lesion for endometrial cancer, clinicians should pay attention to and investigate menstrual bleeding abnormalities of women with FBD and should not delay the evaluation of the endometrium.

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“…Histopathological examination reveals that ductal proliferation leads to ectasia, and the surrounding interlobular tissue undergoes hyalinization and edema [52]. Some clinical data revealed the increased prevalence of BBD among women with luteal phase defect and hyperestrogenemia; however, it is worth emphasizing that other studies do not show any differences in serum hormone concentrations between the studied groups [53,54]. Undoubtedly, the limitation of these studies are often due to small sample size.…”

Section: Introductionmentioning

confidence: 99%

Polycystic Ovary Syndrome and Fibrocystic Breast Disease: An Updated Review

Kunicki

Smolarczyk

2021

Horm Metab Res

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Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in women of reproductive age. There is no clear association between PCOS and benign breast disease (BBD). The latter is a frequent benign disorder, affecting women between 20 and 50 years of age. To date, the classification remains controversial, and the risk of developing breast cancer that is associated with these changes is different depending on the histopathological findings. The most frequent changes are breast cysts, which are noted in up to 50% of patients older than 30 years of age. This up-to-date review presents the relationship between PCOS and BBD. In conclusion, there is no clear association between benign breast disease and PCOS. Further studies on a large population with prospectively collected data using updated PCOS criteria are necessary.

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The Role of E2/P Ratio in the Etiology of Fibrocystic Breast Disease, Mastalgia and Mastodynia

Cited by 9 publications

References 21 publications

Concerns About Breast Pain: How Useful Is Imaging?

Concerns About Breast Pain: How Useful Is Imaging?

The association of fibrocystic breast disease with endometrial histopathological results in abnormal uterine bleeding

Polycystic Ovary Syndrome and Fibrocystic Breast Disease: An Updated Review

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