Benign breast diseases in the focus of proliferative pathology of the reproductive system

Adamyan L.V.; Protasova A.E.; Stepanian A.A.; Alyasova A.V.

doi:https://doi.org/10.17116/repro20243003133

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Abstract:

The mammary gland is a paired organ of the reproductive system, belonging to the type of apocrine glands of the skin. The main function of the mammary gland is the synthesis and secretion of milk. The structure and function of the mammary glands change significantly at different stages of the menstrual cycle, pregnancy and lactation. In the structure of mammary gland diseases there are benign, accounting for 95—97% and representing a heterogeneous group of pathologies and malignant neoplasms, which account for 3—5%. Benign mammary dysplasia (BMD) is a group of diseases characterised by a wide range of proliferative and regressive changes in the gland tissue with disordered ratios of epithelial and connective tissue components. Patients diagnosed with AMD often have gynaecological diseases (menstrual disorders, uterine leiomyoma, endometrial hyperplasia, endometriosis, STD). Such women should form a special group of dispensary observation by a gynaecologist, and their examination and treatment should be aimed at reducing proliferative processes, prevention of progression and recurrence of diseases of the breast and female genital organs. Any patient who comes to a gynaecologist with breast pathology should be fully examined in order to exclude gynaecological diseases. The main principles of prevention of benign breast dysplasia in the practice of obstetrician-gynaecologist should be the earliest possible detection, etiopathogenetic treatment, prevention of abortion, proper management of pregnancy, childbirth and postpartum period and, of course, rational individualised contraception.

Keywords:

benign breast hyperplasia

uterine myoma

endometriosis

endometrial hyperplasia

Authors:

Adamyan L.V.

Russian University of Medicine;
National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov

SPIN RSCI: 9836-2713
Scopus AuthorID: 7006372422
ResearcherID: Q-1722-2018
ORCID: 0000-0002-3253-4512

Protasova A.E.

National Medical Research Centre named after V.A. Almazov;
Saint-Petersburg State University

ORCID: 0000-0001-7930-8048

Stepanian A.A.

Academia of Women’s Health and Endoscopic Surgery

Alyasova A.V.

FSBEI HE «RosUniMed» of MOH of Russia

ORCID: 0000-0003-2621-0359

Received:

24.04.2024

Accepted:

10.05.2024

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References:

Kaprin AD, Rozhkova NI. Mammologiya: nacional’noe rukovodstvo. M.: Ge’otar-Media; 2016. (In Russ.).
Adamyan LV, Andreeva EN, Arty’muk NV, Ashrafyan LA, Belokriniczkaya TE, Dolgushina NV i dr. Klinicheskie rekomendacii. Dobrokachestvennaya displaziya molochnoj zhelezy’. Odobreno Nauchno-prakticheskim Sovetom Ministerstva zdravooxraneniya Rossijskoj Federacii. 2020. Accessed April 27, 2024. (In Russ.). https://cr.minzdrav.gov.ru/schema/598_1?ysclid=lvshavqme466584042
Tazina TV. Pathogenetically justified therapy of cyclic mastalgia. Akusherstvo i ginekologiya. 2020;(9):187-190. (In Russ.). https://doi.org/10.18565/aig.2020.9.187-190
Khashukoeva AZ, Khlynova SA, Ilyina IYu, Kerchelaeva SA. Estrogen-dependent conditions of the female reproductive system: possibilities of non-hormonal therapy using indole-3-carbinol. Akusherstvo i ginekologiya. 2020;(5):65-69. (In Russ.). https://doi.org/10.18565/aig.2020.5.65-69.
Ovsyannikova TV. Benign diseases of the mammary glands — antiproliferative therapy. RMZh. Mat’ i ditya. 2018;(1):67-70. (In Russ.). https://doi.org/10.32364/2618-8430-2018-1-1-67-70
Kravchenko EN, Ozherel’eva MA. The condition of the mammary glands in gynecological diseases (literary review). Mat’ i ditya v Kuzbasse. 2014;2(57):19-23. (In Russ.).
Serov VN, Prilepskaya VN, Ovsyannikova TV. Ginekologicheskaya e’ndokrinologiya. 5-e izd. M.: MedPress-Inform; 2015. (In Russ.).
Dobrokhotova YuE, Narimanova MR, Saprykina LV, Ilyina IYu, Mazo ML. The condition of the mammary glands in premenopausal women with endometrial hyperplasia. Medicinskij sovet. 2021;(3): 120-127. (In Russ.). https://doi.org/10.21518/2079-701X-2021-3-120-127.
Adamyan LV, Priputnevich TV, Pivazyan LG, Muratova KK, Grigoryan IE. Hyperproliferative diseases of the female genital organs and intestinal microbiota: endometriosis, uterine fibroids, endometrial hyperplasia. Problemy’ reprodukcii. 2023;29(4):44-49. (In Russ.). https://doi.org/10.17116/repro20232904144
Kulagina NV. Dobrokachestvenny’e zabolevaniya molochny’x zhelez. Uchebnoe posobie. 2-e izd. M.: «Tipografiya «Pechatny’x del master»; 2012. (In Russ.).
Kogan IYu, Myasnikova MO, Musina EV. Progesteron v lechenii mastopatii. Ajlamazyan E’.K., red. M.: «Tipografiya «Pechatny’x del master»; 2012. (In Russ.).
Smetnik VP, Konovalova VN. The mammary gland as a kind of intracrine organ. Vestnik reproduktivnogo zdorov’ya. 2009;1:39-44. (In Russ.).
Jameson JL, De Groot LJ, de Kretser DM, Giudice LC, Grossman AB, Melmed S, eds. Endocrinology: Adult and Pediatric. 7th ed. vol. 2(Pt 12: Hormonal control of breast development). Philadelphia PA USA: Elsevier; 2016.
Protasova AE, Andreeva EN, Rozhkova NI, Andreeva EN. Dynamics of clinical symptoms of fibrocystic mastopathy on the background of transdermal gel of micronized progesterone: results of the Russian multicenter observational study BREST. Akusherstvo i ginekologiya. 2018;11:138-44. (In Russ.). https://doi.org/10.18565/aig.2018.11.138-134
Bespalov VG, Travina ML. Imbalance of estrogen and progesterone in breast tissue is the main link in the pathogenesis of mastopathy and a factor risk of developing breast cancer. Opuholi zhenskoj reproduktivnoj sistemy. 2015;11(4):58-70. (In Russ.).
Bespalov VG, Travina ML. Fibrocystic disease and breast cancer risk (a review of literature). Opuholi zhenskoj reproduktivnoj sistemy’. 2015;11(4):58-70. (In Russ.). https://doi.org/10.17650/1994-4098-2015-11-4-58-70
Ovsyannikova TV. The possibilities of therapy for dyshormonal pathology of the mammary glands in women with gynecological diseases. Akusherstvo, ginekologiya, reprodukciya. 2010;4(2):28-32. (In Russ.).
Farland LV, Tamimi RM, Eliassen AH, Spiegelman D, Bertrand KA, Missmer SA. Endometriosis and mammographic density measurements in the nurses’ health study II. Cancer Causes and Control. 2016;27(10):1229-1237. https://doi.org/10.1007/s10552-016-0801-y
Andreeva EN, Protasova AE, Raskin GA, Yarmolinskaya MI. Morphological features of benign breast dysplasia in women with endometriosis-associated infertility. RMZh. Medicinskoe obozrenie. 2018; 10:22-25. (In Russ.).
Aganezova NV, Oganezov SS, Shilo MM. Uterine fibroids: modern practical aspects of the disease. Problemy’ reprodukcii. 2022;28 (4): 97-105. (In Russ.). https://doi.org/10.17116/repro20222804197
Smetnik AA, Smetnik VP, Kiselyov VI. Experience in the use of indole-3-carbinol in the treatment of breast diseases and prevention of breast cancer. Akusherstvo i ginekologiya. 2017;(2):106-112. (In Russ.). https://doi.org/10.18565/aig.2017.2.106-12
Ashrafyan LA, Babaeva NA, Antonova IB, Alyoshikova OI, Efanova EV. The importance of estrogenic metabolites in the carcinogenesis of tumors of the female reproductive system. Medicinskij opponent. 2019;(3):34-39. (In Russ.).
Tang Z-R, Zhang R, Lian Z-X, Deng S-L, Yu K. Estrogen-Receptor Expression and Function in Female Reproductive Disease. Cells. 2019;8(10):1123. https://doi.org/10.3390/cells8101123
Persidskaya AA, Huseynova RG, Ordiyants IM. The role of ESR 1 genes of estrogen and PRG progesterone receptors in the development of benign breast dysplasia in women of reproductive age with endometrial hyperplasia. Doktor.Ru. 2021;20(6):68-72. (In Russ.). https://doi.org/10.31550/1727-2378-2021-20-6-68-72
Bhurke AS, Bagchi IC, Bagchi MK. Progesterone-Regulated Endometrial Factors Controlling Implantation. American Journal of Reproductive Immunology. 2016;75(3):237-245. https://doi.org/10.1111/aji.12473
Islam MS, Afrin S, Jones SI, Segars J. Selective Progesterone Receptor Modulators — Mechanisms and Therapeutic Utility. Endocrine Reviews. 2020;41(5):bnaa012. https://doi.org/10.1210/endrev/bnaa012
McKinnon B, Mueller M, Montgomery G. Progesterone resistance in endometriosis: an acquired property? Trends in Endocrinology and Metabolism: TEM. 2018;29(8):535-548. https://doi.org/10.1016/j.tem.2018.05.006
Li Y, Adur MK, Kannan A, Davila J, Zhao Y, Nowak RA, Bagchi MK, Bagchi IC, Li Q. Progesterone alleviates endometriosis via inhibition of uterine cell proliferation, inflammation and angiogenesis in an immunocompetent mouse model. Plos One. 2016;11(10): e0165347. https://doi.org/10.1371/journal.pone.0165347
Donato J, Frazão R. Interactions between prolactin and kisspeptin to control reproduction. Archives of Endocrinology and Metabolism. 2016;60(6):587-595. https://doi.org/10.1590/2359-3997000000230
Auriemma RS, Del Vecchio G, Scairati R, Pirchio R, Liccardi A, Verde N, de Angelis C, Menafra D, Pivonello C, Conforti A, Alviggi C, Pivonello R and Colao A The Interplay Between Prolactin and Reproductive System: Focus on Uterine Pathophysiology. Frontiers in Endocrinology. 2020;11:594370. https://doi.org/10.3389/fendo.2020.594370
Mirabi P, Alamolhoda SH, Golsorkhtabaramiri M, Namdari M, Esmaeilzadeh S. Prolactin concentration in various stages of endometriosis in infertile women. JBRA Assisted Reproduction. 2019; 23(3):225-229. https://doi.org/10.5935/1518-0557.20190020
Mansel RE, Webster DJ, Sweetland HM. Breast pain and nodularity. In: Benign Disorders and Diseases of the Breast. Elsevier; 2009: 107-139.
Prikaz Ministerstva zdravoohraneniya Rossijskoj Federacii ot 20 oktyabrya 2020 g. №1130n «Ob utverzhdenii poryadka okazaniya medicinskoj pomoshchi po profilyu «akusherstvo i ginekologiya». Accessed April 27, 2024. (In Russ.). https://publication.pravo.gov.ru/Document/View/0001202011130037?ysclid=lod9vqq0ra307902625
Garifullova YuV. Radiation methods of diagnosis of benign diseases of the mammary glands. Prakticheskaya medicina. 2017;(7):51-56. (In Russ.).
Heinonen PK. Distribution of female genital tract anomalies in two classifications. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2016; 206:141-146. https://doi.org/10.1016/j.ejogrb.2016.09.009
Farland LV, Tamimi RM, Eliassen AH, Spiegelman D, Collins LC, Schnitt SJ, Missmer SA. A prospective study of endometriosis and risk of benign breast disease. Breast Cancer Research and Treatment. 2016;159:545-552. https://doi.org/10.1007/s10549-016-3957-y
Molochny’e zhelezy’ i ginekologicheskie bolezni. Pod red. VE Radzinskogo. M.: Mediabyuro Status prezens; 2010. (In Russ.).
Lee JH, Kwon S-Y, Chang J, Yuk J-S. Machine Learning Approach to find the relation between Endometriosis, benign breast disease, cystitis and non-toxic goiter. Scientific Reports. 2019;9:5410. https://doi.org/10.1038/s41598-019-41973-w
Doschanova AM. Hormonal therapy of endometriosis and the condition of the mammary glands. Vestnik Ky’rgy’zsko-Rossijskogo slavyanskogo universiteta. 2015;15(4):32-35. (In Russ.).
Moini A, Salari E, Rashidi H, Maajani K, Abedi M, Bayani L, Alipour S. Evaluation of the association of endometriosis and mammographic breast density, a cross-sectional study. BMC Women’s Health. 2022;22:81. https://doi.org/10.1186/s12905-022-01663-8
Kadioğlu N, Yorganci A, Gumgumcu H, Kokanali MK, Ozyer Ş, Ustun Y E. Evaluation of mammographic features in women with adenomyosis. Journal of Experimental and Clinical Medicine. 2022, 39(4): 989-993. https://doi.org/10.52142/omujecm.39.4.13
Vural S, Özdemir O, Sağır M, Soysal Ç, Yılmaz Z. The association of fibrocystic breast disease with endometrial histopathological results in abnormal uterine bleeding. Journal of Surgery and Medicine. 2022;6(7):1115239. https://doi.org/10.28982/josam.1115239
Borovikov IO, Kutsenko II, Bulgakova VP, Borovikova OI. Non-hormonal therapy of patients with fibrocystic mastopathy in combination with endometrial hyperplasia. Meditsinskiy sovet. 2021;(21-1):182-189. (In Russ.). https://doi.org/10.21518/2079-701X-2021-21-1-182-189
Zhang N, Ho S, Mo X, Lin F, Huang W, Luo H. Glucosinolate and Isothiocyanate Intakes Are Inversely Associated with Breast Cancer Risk: A Case-Control Study in China. British Journal of Nutrition. 2018;119(8):957-964. https://doi.org/10.1017/S0007114518000600
Khashukoeva AZ, Khlynova SA, Ilyina IY, Kerchelaeva SA. Estrogen-dependent states of the female reproductive system: the possibility of non-hormonal therapy with the use of indole-3-carbinol. Akusherstvo i ginekologiya. 2020;(5):65-69. (In Russ.). https://doi.org/10.18565/aig.2020.5.65-69
Tixonova NYu. Optimizaciya diagnostiki i kontrolyae’ffektivnosti lecheniya giperplasticheskix processov molochny’x zhelez i matki. Avtoref. diss. …kand. med. nauk. Volgograd, 2011. (In Russ.).
Chernichenko II, Kulakova YuA. Al’ternativnaya terapiya dobrokachestvennoj patologii molochny’x zhelez u zhenshhin reproduktivnogo i peri- i postmenopauzal’nogo vozrastov. Materialy’ X Yubilejnogo mezhdunarodnogo kongressa po reproduktivnoj medicine (19-22 yanvarya 2016 g., Moskva). M.; 2016: 137-139. (In Russ.).
Bostanjyan LL, Prilepskaya VN. Modern trends in the field of hormonal contraception: do I need breaks in taking COCs? Medicinskij opponent. 2019;(3):70-76. (In Russ.).