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World Journal of Surgery

, Volume 13, Issue 6, pp 674–679 | Cite as

The endocrine basis of benign breast disorders

  • Luigi Dogliotti
  • Fabio Orlandi
  • Alberto Angeli
Progress Symposium—Benign Breast Disorders: Fibrocystic Disease? Nondisease? or ANDI?

Abstract

There is sound clinical evidence that many benign breast conditions, especially pain, nodularity, and cysts, are likely to have their pathogenesis in hormonal events during reproductive life. Yet the classical theories of persisting hyperestrogenism and luteal progestogen deficiency have not stood up to detailed investigation. Recent work has demonstrated the importance of dynamic hormonal changes and of chronobiological rhythms—daily, menstrual, and seasonal. Recent developments and findings are reviewed to point to the directions in which the basic etiology of these conditions is likely to be discovered.

Keywords

Clinical Evidence Classical Theory Hormonal Change Hormonal Event Reproductive Life 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

De solides arguments cliniques confirment que bien de symptômes ou maladies bénignes du sein, notamment douleur, nodules, et kystes, trouvent leur explication pathogénétique dans les évènements hormonaux de la patiente fertile. Cependant, les théories classiques de la sécrétion oestrogénique persistante et de la déficience lutéale n'ont pas résisté aux investigations sérieuses. Des travaux récents ont démontré l'importance des variations hormonales dynamiques et des rythmes chronobiologiques—quotidiens, mensuels, et saisonniers. Dans cet article, on fait le point des données et découvertes récentes: l'étiologie de cette pathologie a des chances d'être découverte.

Resumen

Existe evidencia indicativa de que muchas condiciones mamarias benignas, especialmente el dolor, la nodularidad, y los quistes, posiblemente tienen su patogénesis en eventos hormonales que ocurren en el curso de la vida reproductiva. Sin embargo, las teorías clásicas sobre el hiperestrogenismo persistente y la deficiencia de progesterona no han sido motivo de investigación detallada. Trabajos recientes han demostrado la importancia de los cambios dinámicos hormonales y de los ritmos cronobiológicos—diarios, menstruales, y estacionales. Se revisan desarrollos y hallazgos recientes con miras a señalar las direcciones y campos en los cuáles la etiología básica de estas condiciones podría ser dilucidada.

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References

  1. 1.
    Robyn, C.: Endocrinological aspects of breast physiology. In Endocrinology of Cystic Breast Disease, A. Angeli, H.L. Bradlow, L. Dogliotti, editors, New York, Raven Press, 1983, pp. 25–34Google Scholar
  2. 2.
    Withworth, N.S.: Lactation in humans. Psychoneuroendocrinol.13:171, 1988Google Scholar
  3. 3.
    Underwood, L.E., D'Ercole, A.J.: Insulin and insulin-like growth factors/somatomedins in fetal and neonatal development. Clin. Endocrinol. Metab.13:69, 1984Google Scholar
  4. 4.
    Oka, T., Yoshimura, M.: Paracrine regulation of mammary gland growth. Clin. Endocrinol. Metab.15:79, 1986Google Scholar
  5. 5.
    Angeli, A., Dogliotti, L., Faggiuolo, R., Orlandi, F., Bussolati, G.: Fibrocystic Disease of the Breast. A Revisit and New Perspectives, Amsterdam, Excerpta Medica-Elsevier Science Publ., 1984, pp. 1–74Google Scholar
  6. 6.
    Haagensen, C.D.: The normal physiology of the breast. In Diseases of the Breast, C.D. Haagensen, editor, Philadelphia, W.B. Saunders, 1986, pp. 47–55Google Scholar
  7. 7.
    Russo, J., Russo, I.H.: Development of the human mammary gland. In The Mammary Gland, M.C. Neville, C.W. Daniel, editors, New York, 1987, pp. 67–93Google Scholar
  8. 8.
    Hughes, L.E., Mansel, R.E., Webster, D.J.T.: Aberrations of normal development and involution (ANDI): A new perspective on pathogenesis and nomenclature of benign breast disorders. Lancet2:1316, 1987Google Scholar
  9. 9.
    Bradley, C.J., Kledzik, G.S., Meites, J.: Prolactin and estrogen dependency of rat mammary cancer at early and late stages of development. Cancer Res.36:319, 1976Google Scholar
  10. 10.
    Welsch, C.W., Nagasawa, H.: Prolactin and murine mammary tumorigenesis: A review. Cancer Res.37:951, 1977Google Scholar
  11. 11.
    Dogliotti, L., Faggiuolo, R., Muccioli, G., Natoli, V., Sica, G., Di Carlo, F.: Experimental and clinical evidences for a role of prolactin in human breast cancer and the possible usefulness of combining hypoprolatinemic drugs with standard hormonal treatments. In Endocrinology and Malignancy, E.E. Baulieu, S. Jacobelli, W.L. McGuire, editors, Carnforth, The Parthenon Publishing Group, 1986, pp. 168–181Google Scholar
  12. 12.
    Robyn, C., Meuris, S.: Human prolactin: State of the art. In Abstracts of the 5th International Congress on Prolactin, July 13–16, Kyoto, 1988, p. 6Google Scholar
  13. 13.
    Di Carlo, R., Muccioli, G., Bellussi, G., Mussa, A.: Presence and characterization of prolactin receptors in human benign breast tumors. Eur. J. Cancer Clin. Oncol.20:635, 1984Google Scholar
  14. 14.
    Bonneterre, J., Peyrat, J.P., Beuscart, R., Lefebvre, J., Demaille, A.: Prognostic significance of prolactin receptors in human breast cancer. Cancer Res.47:4724, 1987Google Scholar
  15. 15.
    Shiu, R.P.C., Murphy, L.C., Tsuyuki, D., Myal, Y., Lee-Wing, M., Iwasiow, B.: Biological actions of prolactin in human breast cancer. Recent Progr. Hormone Res.43:277, 1987Google Scholar
  16. 16.
    Murphy, L.C., Lee-Wing, M., Goldenberg, G.J., Shiu, R.P.C.: Expression of the gene encoding a prolactin-inducible protein by human breast cancersin vivo: Correlation with steroid receptor status. Cancer Res.47:4160, 1987Google Scholar
  17. 17.
    Peters, F., Schuth, W., Schurich, B., Breckwoldt, M.: Distribution and dynamics of serum prolactin levels in patients with fibrocystic breast disease. Obstet. Gynecol.64:381, 1984Google Scholar
  18. 18.
    Dogliotti, L., Faggiuolo, R., Ferusso, A., Orlandi, F., Sandrucci, S., Tibo, A., Angeli, A.: Prolactin and thyrotropin response to thyrotropin releasing hormone in premenopausal women with fibrocystic disease of the breast. Hormone Res.21:137, 1985Google Scholar
  19. 19.
    Waat-Boolsen, S., Eskildsen, P.C., Blaehr, H.: Release of prolactin, thyrotropin, and growth hormone in women with cyclical mastalgia and fibrocystic disease of the breast. Cancer56:500, 1985Google Scholar
  20. 20.
    Parker, D.C., Rossman, L.G., Vanderlaan, E.F.: Sleep-related nychtohemeral and briefly episodic variations in human plasma prolactin concentrations. J. Clin. Endocrinol. Metab.36:1119, 1973Google Scholar
  21. 21.
    Cole, E.N., Sellwood, R.A., England, P.C., Griffiths, K.: Serum prolactin concentrations in benign breast disease throughout the menstrual cycle. Eur. J. Cancer13:597, 1977Google Scholar
  22. 22.
    Tarquini, B., Gheri, R., Romano, S., Costa, A., Cagnoni, M., Lee, J.K., Halberg, F.: Circadian mesor-hyperprolactinemia in fibrocystic mastopathy. Am. J. Med.66:229, 1979Google Scholar
  23. 23.
    Tarquini, B., Halberg, F.: Altered circannual prolactin and TSH and circadian melatonin rhythm and risk of developing breast cancer. In Chronobiological Approach to Social Medicine, F. Halberg, L. Reale, B. Tarquini, editors, Rome, Istituto Italiano di Medicina Sociale, 1986, pp. 127–148Google Scholar
  24. 24.
    Bruning, P.F., Bonfrer, M., De Jong-Bakker, M., Hart, A.A.M., Misdorp, W., Nooyen, W., Kwa, H.G.: Hormone profiles in premenopausal “benign breast disease.” In Abstracts of the 3rd EORTC Breast Cancer Working Conference, Amsterdam, Netherland's Organization for Cancer Research, 1983, p. VII-7Google Scholar
  25. 25.
    Tarquini, B., Cariddi, A., Granelli, A., Mainardi, G., Sensi, G., Moggi, P., Zennaro, R., Cecchettin, M.: Multiple prolactin dyschronias in benign breast disease (BBD). In Social Diseases and Chronobiology, B. Tarquini, editor, Bologna, Esculapio Publ. Co., 1987, pp. 39–51Google Scholar
  26. 26.
    Melis, G.B., Guarneri, G., Paoletti, A.M., Petacchi, F.D., Ricci, D., Strigini, F., Selli, M., Ruju, A., Fioretti, P.: Clinical significance of hormonal evaluations in peripheral blood and in breast cyst fluid of women with benign breast disease. In Endocrinology of Cystic Breast Disease, A. Angeli, H.L. Bradlow, L. Dogliotti, editors, New York, Raven Press, 1983, pp. 101–112Google Scholar
  27. 27.
    Kumar, S., Mansel, R.E., Hughes, L.E., Woodhead, J.S., Edwards, C.A., Scanlon, M.F., Newcombe, R.G.: Prolactin response to thyrotropin-releasing hormone stimulation and dopaminergic inhibition in benign breast disease. Cancer53:1311, 1984Google Scholar
  28. 28.
    Aragona, C., Figliolini, M., Tribulato, E., Vetrano, G., Spera, G., Custo, G.M., Pozzi, V.: Studio della prolattina e del progesterone in pazienti con mastopatia fibrocistica sintomatica e asintomatica. Giorn. Ital. Senol.2:1, 1981Google Scholar
  29. 29.
    Dogliotti, L., Faggiuolo, R., Orlandi, F., Torta, M., Meda, E., Angeli, A.: Prolactin dynamics after acute stimulation with thyrotropin-releasing hormone and domperidone in women with fibrocystic disease of the breast. In Endocrinology of the Breast: Basic and Clinical Aspects, A. Angeli, H.L. Bradlow, L. Dogliotti, editors, New York, The New York Academy of Science, 1986, pp. 589–591Google Scholar
  30. 30.
    De Brux, J.: Histoire naturelle et diagnostic de quelques lésions mammaires. Rev. Fr. Gynécol.68:365, 1973Google Scholar
  31. 31.
    Mauvais-Jarvis, P., Sitruk-Ware, R., Kuttenn, F., Sterkers, N.: Luteal phase insufficiency: A common pathophysiological factor in development of benign and malignant breast disease. In Commentaries on Research in Breast Disease, R.D. Bulbrook, D.J. Taylor, editors, New York, Alan R. Liss, 1979, pp. 25–29Google Scholar
  32. 32.
    England, P.C., Skinner, L.G., Cottrell, K.R., Sellwood, R.A.: Sex hormones in breast disease. Br. J. Surg.62:806, 1975Google Scholar
  33. 33.
    Mauvais-Jarvis, P., Mutten, F., Mowszowics, I., Sitruk-Ware, R.: Mastopathies benignes: Étude hormonale chez 125 malades. Nouv. Presse Med.6:1115, 1977Google Scholar
  34. 34.
    Sitruk-Ware, L.R., Sterkers, N., Mowszowics, I., Mauvais-Jarvis, P.: Inadequate corpus luteal function in women with benign breast disease. J. Clin. Endocrinol. Metab.44:771, 1977Google Scholar
  35. 35.
    Malarkey, W.B., Schroeder, L.L., Stevens, V.C., James, A.G., Lanese, R.R.: Twenty-four hours preoperative endocrine profiles in women with benign and malignant breast disease. Cancer Res.37:4655, 1977Google Scholar
  36. 36.
    Walsh, P., Bulbrook, R.D., Stell, P.M., Wang, D.Y., McDicken, I.W., George, W.D.: Serum progesterone concentration during the luteal phase in women with benign breast disease. Eur. J. Cancer Clin. Oncol.20:1339, 1984Google Scholar
  37. 37.
    Read, G.F., Bradley, J.A., Wilson, D.W., George, W.D., Griffiths, K.: Evaluation of luteal-phase salivary progesterone levels in women with benign breast disease or primary breast cancer. Eur. J. Cancer Clin. Oncol.21:9, 1985Google Scholar
  38. 38.
    Angeli, A., Faggiuolo, R., Berruti, A.: Abnormalities of prolactin secretion in patients with fibrocystic breast disease. In Fibrocystic Breast Disease, L. Dogliotti, R.E. Mansel, editors. Aulendorf, Editio Cantor, 1986, pp. 21–29Google Scholar
  39. 39.
    Pfeiffer, A., Herz, A.: Endocrine action of opioids. Horm. Metab. Res.16:386, 1984Google Scholar
  40. 40.
    Pontiroli, A.E., Baio, G., Stella, L., Crescenti, A., Girardi, A.M.: Effects of naloxone on prolactin, luteinizing hormone and cortisol responses to surgical stress in humans. J. Clin. Endocrinol. Metab.55:378, 1982Google Scholar
  41. 41.
    Santen, R.J., Leszczynski, D., Tilson-Mallet, N., Feil, P.D., Wright, C., Manni, A., Santner, S.J.: Enzymatic control of estrogen production in human breast cancer: Relative significance of aromatase versus sulfatase pathways. In Endocrinology of the Breast: Basic and Clinical Aspects, A. Angeli, H.L. Bradlow, L. Dogliotti, editors, New York, The New York Academy of Sciences, 1986, pp. 126–137.Google Scholar
  42. 42.
    Santner, S., Leszczynski, D., Wright, C., Manni, A., Feil, P.D., Santen, R.J.: Estrone sulfate: A potential source of estradiol in human breast cancer tissues. Breast Cancer Res. Treat.7:35, 1986Google Scholar
  43. 43.
    Vermeulen, A., Deslypere, J.P., Paridaens, R.: Steroid dynamics in the normal and carcinomatous mammary gland. J. Steroid Biochem.25:799, 1986Google Scholar
  44. 44.
    Thijssen, J.H.H., Van Landeghem, A.A.J., Poortman, J.: Uptake and concentration of steroids hormones in mammary tissues. In Endocrinology of the Breast: Basic and Clinical Aspects, A. Angeli, H.L. Bradlow, L. Dogliotti, editors, New York, The New York Academy of Sciences, 1986, pp. 106–116.Google Scholar
  45. 45.
    Dickson, R.B., Lippman, M.E.: Estrogenic regulation of growth and polypeptide growth factor secretion in human breast carcinoma. Endocrine Rev.8:29, 1987Google Scholar
  46. 46.
    Azzopardi, J.G.: Problems in Breast Pathology, Philadelphia, W.B. Saunders, 1979Google Scholar
  47. 47.
    Haagensen, C.D., Bodian, C., Haagensen, Jr., D.E.: Breast Carcinoma. Risk and Detection, Philadelphia, W.B. Saunders, 1981Google Scholar
  48. 48.
    Bradlow, H.L., Rosenfeld, R.S., Kream, J., Fleisher, M., O'Connor, J., Schwartz, M.K.: Steroid hormone accumulation in human breast cyst fluid. Cancer Res.41:105, 1981Google Scholar
  49. 49.
    Frairia, P., Agrimonti, F., Fazzari, A.M., Barbadoro, E., Boccuzzi, G., Angeli, A.: Evidence for a transcortin-like component in human breast cyst fluid. Clin. Chim. Acta131:15, 1983Google Scholar
  50. 50.
    Rosner, W., Saeed Khan, M., Breed, C.N., Fleisher, M., Bradlow, H.L.: Plasma steroid-binding proteins in the cysts of gross cystic disease of the breast. J. Clin. Endocrinol. Metab.61:200, 1985Google Scholar
  51. 51.
    Angeli, A., Dogliotti, L., Agrimonti, F., Faggiuolo, R., Cavallo, R., Tibo, A.: Thyroid hormone levels in human breast cyst fluid. Acta Endocrinol.107:230, 1984Google Scholar
  52. 52.
    Fleisher, M., Robbins, G.F., Breed, C.N., Fracchia, A.A., Urban, J.A., Schwartz, M.K.: The biochemistry of breast cyst fluid. Memorial Sloan Kettering Cancer Center Clin. Bull.3:94, 1973Google Scholar
  53. 53.
    Miller, W.R., Dixon, J.M., Scott, W.N., Forrest, A.P.M.: Classification of human breast cysts according to electrolyte and androgen conjugate composition. Clin. Oncol.9:227, 1983Google Scholar
  54. 54.
    Dogliotti, L., Orlandi, F., Torta, M., Buzzi, G., Naldoni, C., Mazzotti, A., Angeli, A.: Cations and dehydroepiandrosterone-sulfate in cyst fluid of pre- and menopausal patients with gross cystic disease of the breast. Evidence for the existence of subpopulations of cysts. Eur. J. Cancer Clin. Oncol.22:1307, 1986Google Scholar
  55. 55.
    Dixon, J.M., Miller, W.R., Scott, W.N., Forrest, A.P.M.: The morphological basis of human breast cyst populations. Br. J. Surg.70:604, 1983Google Scholar
  56. 56.
    Beccati, D., Grilli, N., Schincaglia, P., Naldoni, C., Tavolazzi, L., Ranaldi, R., Dogliotti, L., Torta, M., Angeli, A.: Apocrine cells in breast cyst fluid and their relationship to cyst type: A morphometric study. Eur. J. Cancer Clin. Oncol.24:597, 1988Google Scholar
  57. 57.
    Hawkins, R.A., Thomson, M.L., Killen, E.: Oestrone sulphate, adipose tissue, and breast cancer. Breast Cancer Res. Treat.6:75, 1985Google Scholar
  58. 58.
    Miller, W.R., Humeniuk, V., Kelly, R.W.: Dehydroepiandrosterone sulphate in breast secretions. J. Steroid Biochem.137:145, 1980Google Scholar
  59. 59.
    Boccuzzi, G., Brignardello, E., Massobrio, M., Bonino, L.: Breast duct fluid dehydroepiandrosterone sulphate in fibrocystic disease. Eur. J. Cancer Clin. Oncol.23:1099, 1987Google Scholar
  60. 60.
    Rose, D.P., Berke, B., Cohen, L.A., Lahti, H.: A Comparison of serum and breast duct fluid immunoassayable prolactin and growth hormone with bioassayable lactogenic hormones in healthy women and patients with cystic disease. Cancer60:2761, 1987Google Scholar
  61. 61.
    Tanaka, T., Shiu, R.P.C., Gout, P.W., Beer, C.T., Noble, R.L., Friesen, H.G.: A new sensitive and specific bioassay for lactogenic hormones: Measurement of prolactin and growth hormone in human serum. J. Clin. Endocrinol. Metab.51:1058, 1980Google Scholar

Copyright information

© Société Internationale de Chirurgie 1989

Authors and Affiliations

  • Luigi Dogliotti
    • 1
  • Fabio Orlandi
    • 1
  • Alberto Angeli
    • 1
  1. 1.Department of Biomedicine, Clinical Oncology, and Internal MedicineUniversity of TorinoTorinoItaly

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