Effect of oral contraceptive with and without associated estriol on ultrasound measurements of breast fibroadenoma

randomized clinical trial

Authors

  • Rodrigo Augusto Fernandes Estevão Universidade Federal de São Paulo — Escola Paulista de Medicina
  • Afonso Celso Pinto Nazário Universidade Federal de São Paulo — Escola Paulista de Medicina
  • Edmund Chada Baracat Universidade Federal de São Paulo — Escola Paulista de Medicina

Keywords:

Fibroadenoma, Contraceptives, oral, Estriol, Ultrasonics, Growth substances

Abstract

CONTEXT AND OBJECTIVE: Fibroadenomas are the most common benign tumors of the female breast. The aim of this study was to evaluate the proliferative activity of breast fi broadenoma as shown by ultrasound measurements, following administration of oral contraceptives with and without associated estriol. DESIGN AND SETTING: This was a randomized, double-blind, placebo-controlled clinical trial carried out in the Mastology Sector, Department of Gynecology, Universidade Federal de São Paulo. METHODS: We studied 33 women with fi broadenomas. Ten were placed in group 1 and took an oral contraceptive consisting of levonorgestrel and ethinyl estradiol together with placebo material in the same capsule, for four consecutive cycles with a seven-day interval between them. The other 23 patients constituted group 2 and took the oral contraceptive as above together with estriol in the same capsule, in the same way as done by the group 1 patients. We took ultrasound measurements of their tumors (in three dimensions) before and after the intake of medication. At the end of the study, all the patients had their tumors removed by surgery. RESULTS: We observed decreased fibroadenoma width among the users of oral contraceptives with placebo, and this decrease was statistically signifi cant. In the other group, we did not observe any changes (in width, length or height). CONCLUSION: The results confi rm that estriol may block the protective effect of oral contraceptives on fi broadenomas, since we observed decreased fi broadenoma width among the group 1 patients but not the group 2 patients.

Downloads

Download data is not yet available.

Author Biographies

Rodrigo Augusto Fernandes Estevão, Universidade Federal de São Paulo — Escola Paulista de Medicina

MD. Postgraduate student in the Mastology Sector, Department of Gynecology, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

Afonso Celso Pinto Nazário, Universidade Federal de São Paulo — Escola Paulista de Medicina

MD, PhD. Head professor of the Mastology Sector, Department of Gynecology, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

Edmund Chada Baracat, Universidade Federal de São Paulo — Escola Paulista de Medicina

MD, PhD. Full professor of the Department of Gynecology, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

References

Dent DM, Cant PJ. Fibroadenoma. World J Surg. 1989;13(6):706-10.

Alle KM, Moss J, Venegas RJ, Khalkhali I, Klein SR. Con- servative management of fibroadenoma of the breast. Br J Surg. 1996;83(7):992-3.

Greenberg R, Skornick Y, Kaplan O. Management of breast fibroadenomas. J Gen Intern Med. 1998;13(9):640-5.

Funderburk WW, Rosero E, Leffall LD. Breast lesions in blacks. Surg Gynecol Obstet. 1972;135(1):58-60.

Nigro DM, Organ CH Jr. Fibroadenoma of the female breast. Some epidemiologic surprises. Postgrad Med. 1976;59(5):113-7.

Bartow SA, Pathak DR, Black WC, Key CR, Teaf SR. Prevalence of benign, atypical, and malignant breast lesions in populations at different risk for breast cancer. A forensic autopsy study. Cancer. 1987;60(11):2751-60.

Haagensen CD. Diseases of the breast. 3rd ed. Philadelphia: WB Saunders; 1986.

Carty NJ, Carter C, Rubin C, Ravichandran D, Royle GT, Taylor I. Management of fibroadenoma of the breast. Ann R Coll Surg Engl. 1995;77(2):127-30.

Wilkinson S, Anderson TJ, Rifkind E, Chetty U, Forrest AP. Fibroadenoma of the breast: a follow-up of conservative manage- ment. Br J Surg. 1989;76(4):390-1.

Sitruk-ware LR, Sterkers N, Mowszowicz I, Mauvais-Jarvis P. Inadequate corpus luteal function in women with benign breast diseases. J Clin Endocrinol Metab. 1977;44(4):771-4.

Monterrosa Castro A. Actualización de conceptos en anticoncep- tivos orales combinados [monograph online]. 2nd ed. Colombia; 2000. Available from: http://encolombia.com/anticonceptivos1. htm. Accessed in 2007 (Aug 14).

Krattenmacher R. Drospirenone: pharmacology and phar- macokinetics of a unique progestogen. Contraception. 2000;62(1):29-38.

Borgelt-Hansen L. Oral contraceptives: an update on health benefits and risks. J Am Pharm Assoc (Wash). 2001;41(6):875- 86, quiz 925-6.

Mishell DR Jr, Kletzky OA, Brenner PF, Roy S, Nicoloff J. The effect of contraceptive steroids on hypothalamic-pituitary function. Am J Obstet Gynecol. 1977;128(1):60-74.

Cohen BL, Katz M. Pituitary and ovarian function in women receiving hormonal contraception. Contraception. 1979;20(5):475-87.

Lobo RA, Stanczyk FZ. New knowledge in the physiology of hormonal contraceptives. Am J Obstet Gynecol. 1994;170(5 Pt 2):1499-507.

Ravnihar B, Siegel DG, Lindtner J. An epidemiologic study of breast cancer and benign breast neoplasias in relation to the oral contracep- tive and estrogen use. Eur J Cancer. 1979;15(4):395-405.

Sitruk-Ware R, Thalabard JC, Benotmane A, Mauvais-Jarvis P. Risk factors for breast fibroadenoma in young women. Contraception. 1989;40(3):251-68.

Speroff L, Glass RH, Kase NG. Endocrinologia ginecológica clínica e infertilidade. 5th ed. São Paulo: Manole; 1995.

Neter J, Wasserman W, Kutner MH. Applied linear statistical models. 3rd ed. New York: Irwin Inc; 1990.

Conover WJ. Practical nonparametric statistics. 2nd Edition. New York: John & Sons; 1980.

Zamith R, Lima GR. Contracepção na adolescência. In: Lima GR, Girão MJBC, Baracat EC, editors. Ginecologia de consultório. São Paulo: EPM — Editora de Projetos Médicos; 2003. p 147-56.

Epithelial ovarian cancer and combined oral contraceptives. The WHO Collaborative Study of Neoplasia and Steroid Contracep- tives. Int J Epidemiol. 1989;18(3):538-45.

Combination oral contraceptive use and the risk of endometrial cancer. The Cancer and Steroid Hormone Study of the Centers for Disease Control and the National Institute of Child Health and Human Development. JAMA. 1987;257(6):796-800.

Leonardi M. Contraccezione ormonale e patologia mammaria be- nigna. Valutazione di un protocollo di trattamento nella mastopatia cronica con mastalgia. [Hormonal contraception and benign breast disease. Evaluation of a treatment protocol for chronic mastopathy with mastalgia]. Minerva Ginecol. 1997;49(6):271-6.

Brinton LA, Vessey MP, Flavel R, Yeates D. Risk factors for benign breast disease. Am J Epidemiol. 1981;113(3):203-14.

Sawhney N, Garrahan N, Douglas-Jones AG, Williams ED. Epithelial-stromal interactions in tumors. A morphologic study of fibroepithelial tumors of the breast. Cancer. 1992;70(8):2115-20.

Hasebe T, Imoto S, Sasaki S, Tsubono Y, Mukai K. Proliferative activity and tumor angiogenesis is closely correlated to stromal cellularity of fibroadenoma: proposal fibroadenoma, cellular variant. Pathol Int. 1999;49(5):435-43.

Pasqualini JR, Cortes-Prieto J, Chetrite G, Talbi M, Ruiz A. Concentrations of estrone, estradiol and their sulfates, and evaluation of sulfatase and aromatase activities in patients with breast fibroadenoma. Int J Cancer. 1997;70(6):639-43.

Kuijper A, Buerger H, Simon R, et al. Analysis of the progression of fibroepithelial tumours of the breast by PCR-based clonality assay. J Pathol. 2002;197(5):575-81.

Canny PF, Berkowitz GS, Kelsey JL, LiVolsi VA. Fibroadenoma and the use of exogenous hormones. A case-control study. Am J Epidemiol. 1988;127(3):454-61.

Rohan TE, Miller AB. A cohort study of oral contraceptive use and risk of benign breast disease. Int J Cancer. 1999;82(2):191-6.

Yu H, Rohan TE, Cook MG, Howe GR, Miller AB. Risk fac- tors for fibroadenoma: a case-control study in Australia. Am J Epidemiol. 1992;135(3):247-58.

Hardman JG, Limbird LE, Molinoff PB, Ruddon RW, Gilman AG. Goodman and Gilman’s: the pharmacological basis of therapeutics. 9th ed. New York: McGraw Hill; 1996.

Umekita Y, Yoshida H. Immunohistochemical study of MIB1 expression in phyllodes tumor and fibroadenoma. Pathol Int. 1999;49(9):807-10.

Downloads

Published

2007-09-09

How to Cite

1.
Estevão RAF, Nazário ACP, Baracat EC. Effect of oral contraceptive with and without associated estriol on ultrasound measurements of breast fibroadenoma: randomized clinical trial. Sao Paulo Med J [Internet]. 2007 Sep. 9 [cited 2025 Oct. 16];125(5):275-80. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2160

Issue

Section

Original Article