scholarly journals The effect of Metformin on fibrocystic breast disease in women with insulin resistance

2018 ◽  
Vol 14 (3) ◽  
pp. 19-24
Author(s):  
E. V. Musina ◽  
I. Y. Kogan
Keyword(s):  
Insulin Resistance ◽  
Mammary Gland ◽  
Structural Changes ◽  
Clinical Course ◽  
Dynamic Control ◽  
Breast Disease ◽  
Mammary Glands ◽  
Positive Influence ◽  
Treatment And Prevention ◽  
Fibrocystic Breast Disease

A little studied question is the development mechanism, timely diagnostics, treatment and prevention of the fibrocystic breast disease at patients with insulin resistance. One of the possible perspective directions of pathogenetic impact on tissues of a mammary gland at the mastopathy associated with a giperinsulinemiya and insulin resistance is use of metformin. Now clinical trials on use of metformin at cancer of mammary glands continue. Data on use of medicines of this group at patients with fibrocystic breast disease in domestic and foreign literature are absent.Objective:assessment of influence of metformin on clinical displays of fibrocystic breast disease and ultrasonic characteristics of a parenchyma of mammary glands at patients with insulin resistance.Materials and methods.As therapy of fibrocystic breast disease patients received metformin in a dose of 1500 mg a day. Dynamic control of a clinical picture of a disease and ultrasonic indicators of a parenchyma of a mammary gland carried out in 3 and 6 months from the beginning of therapy.Results and conclusion.In 6 months of therapy there was a reliable decrease in frequency of a mastalgiya, change of an ultorasound picture of mammary glands: echogenicity of a parenchyma of mammary glands – became sredeny in 95,9% of cases, there was a reliable reduction of thickness of a parenchyma of mammary glands (from 15.5 mm to 10. 5 mm) and diameter of lacteal channels (from 1.7 mm to 0.9 mm). The obtained data on positive influence of metformin on the clinical course of mastopathy and structural changes of a parenchyma of mammary glands at patients with fibrocystic breast disease and insulin resistance allow to consider similar approach as the perspective direction of pathogenetic influence at such pathological association.

scholarly journals Experience in treating breast pathology in outpatient practice

2020 ◽  
pp. 95-102
Author(s):  
M. Yu. Myasnyankin ◽  
V. V. Anisimov
Keyword(s):  
Staphylococcus Aureus ◽  
Mammary Gland ◽  
Breast Disease ◽  
Mammary Glands ◽  
The Body ◽  
Evidence Based ◽  
Adequate Treatment ◽  
Bacteriological Study ◽  
Fibrocystic Breast Disease ◽  
Starting Point

Introduction. According to epidemiological researches, such mammary gland disease as fibrocystic breast disease takes the leading place in the structure of pre-tumor diseases in women. Pathological cell proliferation is the common starting point for pathogenesis of both mastopathy and breast cancer. Patients with fibrocystic breast disease complain of pain unrelated to the menstrual cycle in the area of the mammary glands, swelling of breast tissue, nipple discharge. An important problem is the effective treatment of mastitis and lactostasis, during and after which the possibility of breastfeeding was maintained. Mastitis is a formidable complication of the postpartum period and the cause of lactation failure. For a long time, all patients with infectious mastitis underwent surgical treatment of the area of infection with subsequent drainage. As a rule, with the prescription of broad spectrum antibiotic drugs. Often, against the background of such stress for the body the ability to breastfeed dies down. Timely diagnosis and adequate treatment of mastitis and lactostasis help to preserve breastfeeding and improve the health of mother and child. Treatment of mastitis and lactostasis, fibrocystic breast disease is a complex problem of modern mammology.Aim. This paper presents a pathogenetic approach to the treatment of fibrocystic breast disease from the point of view of evidence-based medicine using micronized progesterone. In order to avoid surgical interventions on the mammary glands and to preserve the maximum possible period of breastfeeding, we studied and proposed the method of mini-invasive and evidence-based approach to the treatment and prophylaxis of mastitis and lactostasis using a drug containing the strain L. Fermentum CECT5716.Materials and methods. 13 patients with mastitis symptoms were included in the study. The main complaint of all patients who applied was lactostasis (100%). According to breast ultrasound, most patients were diagnosed with infiltrative mastitis – 8 (61.5%), serous mastitis – 4 (30.7%). Only one patient was diagnosed with purulent mastitis (7.7%). After prescription of treatment for mastitis and lactostasis after 21 days of clinical and radiological mammary gland image in 10 cases (77%) without pathology, duct ectasia was found in three women, which is the physiological norm in breastfeeding. All breastfeeding women have recovered normal lactation without symptoms of lactostasis. Almost all patients according to pain VAS noted not exceeding 1 point (mean was 1 ± 0.7). In most cases, the punctate cytogram corresponded to acute inflammation and purulent inflammation, 7 (53.9%) and 6 (46.1%). Results of a bacteriological study: Staphylococcus aureus – 11 (84.6%). Three patients had mixed microflora, Staphylococcus aureus/Staphylococcus epidermidis and Staphylococcus aureus/Staphylococcus saprophyticus, 2 (15.3%) and 1 (7.7%), respectively. One patient was diagnosed with Enterococcus faecalis. These data affected the choice of therapy. All patients were prescribed therapy with a drug containing the strain of L. Fermentum CECT5716 one capsule per day for 28 days, with subsequent assessment of the therapeutic effect on the 10th, 21st days.Results. After treatment on the 10th day of control examination all the patients had galactorrhea cytogram without morphological signs of inflammation. According to the data of the bacteriological study of cultures, complete elimination of pathogenic microflora was revealed in most cases – 8 (61,5%), in 5 patients there were titers of less than 104 CFU/ml, which was the norm indicator. Clinical examples of treatment are given.Conclusions. Our experience in treating such patients with a drug containing the strain L. Fermentum CECT5716 can successfully replace the standard of medical care for the treatment of mastitis and lactostasis. However, a combination with antibiotic therapy can be used for high bacterial load and mixed microflora. In all cases (100%) on the 10th day after the start of therapy all symptoms and clinical and radiological signs of lactostasis and mastitis were cured.

scholarly journals Application possibilities of biguanides for fibrocystic breast disease in women of reproductive age

2019 ◽  
Vol 68 (3) ◽  
pp. 35-40 ◽  
Author(s):  
Ekaterina V. Musina ◽  
Igor Yu. Kogan
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Breast Disease ◽  
Breast Ultrasound ◽  
Reproductive Age ◽  
Childbearing Age ◽  
Actual Problem ◽  
Female Population ◽  
Fibrocystic Mastopathy ◽  
Fibrocystic Breast Disease

Hypothesis/aims of study. The ongoing global problem of health care and medical science is an associated increase in the frequency of endocrine and metabolic diseases and cancer, including in women of childbearing age. Thus, the frequency of diabetes in the population has been growing rapidly for many years. Similar trends were observed in the dynamics of the frequency of cancer pathology, especially of breast cancer, which is one of the leading places in the structure of the cancer incidence in the female population. It is known that diabetes and related insulin resistance have a very negative effect on the female reproductive function, leading to hyperplastic processes of the mammary glands. The least studied problem so far is understanding the mechanisms of development, timely diagnosis, prevention, and treatment of fibrocystic mastopathy, the proliferative forms of which underlie malignant tumors, while its atypical variations are regarded as a precancerous condition. It is likely that the pathogenesis of hyperplastic processes in the mammary gland and the risk of neoplastic transformation in disorders of carbohydrate metabolism may have special factors. The actual problem is the development of a method for pathogenetically substantiated correction of fibrocystic breast disease. This is essential for the development of pharmacological strategies for secondary prevention of breast cancer and, in this regard, it is of great interest to study application possibilities of biguanides. The purpose of the present study was to conduct a comparative assessment of the effectiveness of metformin therapy in fibrocystic mastopathy patients with and without insulin resistance. Study design, materials, and methods. The study involved 120 women, aged 18 to 40 years inclusive, with clinical and / or ultrasound signs of fibrocystic breast disease. According to the results of calculating HOMA index, patients were divided into two groups: the first group comprised 66 patients with insulin resistance (HOMA > 2.5) and the second group consisted of 54 patients with no insulin resistance (HOMA < 2.5). Assessment of mastalgia was performed using the Visual Analogue Scale. Breast ultrasound examination was performed on days 5 to 7 of the menstrual cycle. For the purpose of quantitative image analysis of the breast parenchyma, the following parameters were evaluated: a) thickness of the parenchyma (fibroglandular zone); b) diameter of the milk ducts; c) echogenicity. All patients received metformin at a dose of 1500 mg per day. Dynamic control of the clinical picture of the disease, as well as of mammographic breast parenchymal pattern, was performed after 3 and 6 months from the start of therapy. Results and conclusion. After 6 months of therapy, there was a decrease in the frequency of mastalgia, and significant changes in breast ultrasound picture were observed. The data obtained on the positive effect of metformin on clinical mastitis and structural changes in the mammary parenchyma in patients with mastopathy allow considering such an approach as a promising therapeutic strategy in this pathological association.

The effect of bromocriptine on mammary-gland ultrastructure of hyperprolactinemic rats

1984 ◽  
Vol 42 ◽  
pp. 204-205
Author(s):  
I.C. Murray
Keyword(s):  
Mammary Gland ◽  
Dopamine Agonist ◽  
Alveolar Epithelium ◽  
Mammary Glands ◽  
Female Rats ◽  
Control Group ◽  
Cell Hyperplasia ◽  
Once Daily ◽  
Long Evans

In women, hyperprolactinemia is often due to a prolactin (PRL)-secreting adenoma or PRL cell hyperplasia. RRL excess stimulates the mammary glands and causes proliferation of the alveolar epithelium. Bromocriptine, a dopamine agonist, inhibits PRL secretion and is given to women to treat nonpuerperal galactorrhea. Old female rats have been reported to have PRL cell hyperplasia or adenoma leading to PRL hypersecretion and breast stimulation. Herein, we describe the effect of bromocriptine and consequently the reduction in serum PRL levels on the ultrastructure of rat mammary glands.Female Long-Evans rats, 23 months of age, were divided into control and bromocriptine-treated groups. The control animals were injected subcutaneously once daily with a 10% ethanol vehicle and were later divided into a normoprolactinemic control group with serum PRL levels under 30 ng/ml and a hyperprolactinemic control group with serum PRL levels above 30 ng/ml.

INTERACTIONS OF OESTRONE AND TESTOSTERONE ON MAMMARY GLANDS OF MALE RABBITS

1961 ◽  
Vol 36 (1) ◽  
pp. 141-156 ◽  
Author(s):  
B. Bengtsson ◽  
A. Norgren
Keyword(s):  
Mammary Gland ◽  
Testosterone Propionate ◽  
Mammary Glands ◽  
List Type ◽  
Stunted Growth ◽  
Abnormal Growth ◽  
Growth Reaction ◽  
Extensive Growth ◽  
Higher Doses

ABSTRACT The effect of testosterone and oestrone on the mammary glands of castrated male rabbits was studied. Testosterone propionate was used in daily doses from 0.5 to 80 mg. The doses of oestrone ranged from 0.05 to 25 μg per day. Mammary glands were examined after 14, 28 or 56 days of injections. 1) Testosterone in doses below 20 mg failed to affect the mammary glands. With 40 or 80 mg a distinct, though abnormal growth reaction was consistently obtained. 2) Oestrone in doses lower than 0.5 μg did not stimulate mammary growth. With 0.5 μg and higher doses extensive growth of the mammary glands occurred. Stunted growth and secretion were found in the mammary glands of rabbits injected with 12.5 or 25 μg oestrone. 3) Testosterone in doses of 1 or 5 to 10 mg depressed or abolished the response of the mammary glands to 0.5 μg oestrone. When testosterone, in doses ineffective when given alone, was added to at least 3.125 μg oestrone, the mammary glands developed alveoli. The abnormalities produced by the highest doses of oestrone studied were exaggerated by the addition of testosterone. 4) The observations indicate a complicated interplay between the actions of testosterone and oestrone on the mammary gland of the rabbit. The interactions between testosterone and oestrone are presumably different from those observed between progesterone and oestrone.

EFFECT OF LOCALLY IMPLANTED OESTROGEN ON THE RESPONSE OF THE RAT'S LACTATING MAMMARY GLAND TO OXYTOCIN

1973 ◽  
Vol 73 (4) ◽  
pp. 700-712 ◽  
Author(s):  
J. D. Bruce ◽  
X. Cofre ◽  
V. D. Ramirez
Keyword(s):  
Mammary Gland ◽  
Mammary Glands ◽  
Myoepithelial Cells ◽  
Recording System ◽  
Saline Infusion ◽  
High Dose ◽  
Low Doses ◽  
Milk Ejection ◽  
Lactating Mammary Gland ◽  
Small Rise

ABSTRACT On the day following delivery (day 1 of lactation) one abdominal mammary gland was implanted with oestrogen and the contralateral gland received an empty needle. At 2, 5 or 10 days of lactation the rats were anaesthetized with pentobarbital and the nipples of both abdominal glands were cannulated and their pressures recorded by means of transducers coupled to an amplifier and recording system. The normal mammary glands of 5-day lactating rats responded to very low doses of oxytocin (Syntocinon®, Sandoz) (5× 10−8 mU) with a rhythmic elevation in pressure. However, saline infusion also evoked a small rise in intra-mammary pressure. Earlier (2 days) and later (10 days) in lactation the responses were smaller. Oestrogen decreases significantly the milk ejection response to oxytocin, and the effect was maximal at day 10 of lactation. Histological observations confirmed the diminished reaction of the gland to oxytocin, since the milk was retained in the alveoli of rats bearing a mammary-oestrogen implant. A paradoxical rise in pressure was detected in normal as well as in oestrogen-implanted glands when the lowest dose of oxytocin was injected in lactating rats which had previously received a high dose of oxytocin (50 mU or 500 mU). These results reinforce the hypothesis that oestrogen alters the milk ejection response to oxytocin and that the mechanism is probably related to changes in the contractility of the myoepithelial cells.

Polycystic ovary syndrome and fibrocystic breast disease: is there any association?

2009 ◽  
Vol 280 (2) ◽  
pp. 249-253 ◽  
Author(s):  
Ilknur Inegol Gumus ◽  
Asli Koktener ◽  
Dilek Dogan ◽  
Nilgun Ozturk Turhan
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Breast Disease ◽  
Ovary Syndrome ◽  
Fibrocystic Breast Disease

scholarly journals Regulation of lipogenic capacity in lactating rats

1982 ◽  
Vol 208 (3) ◽  
pp. 611-618 ◽  
Author(s):  
M R Grigor ◽  
A Geursen ◽  
M J Sneyd ◽  
S M Warren
Keyword(s):  
Mammary Gland ◽  
Fatty Acid ◽  
Malic Enzyme ◽  
Fatty Acid Synthase ◽  
Specific Activity ◽  
Mammary Glands ◽  
Lipogenic Enzymes ◽  
Pregnancy And Lactation ◽  
Specific Activities

1. The rate of mammary-gland lipogenesis measured in vivo from 3H2O was suppressed after decreasing the milk demand by decreasing the number of pups from ten to two or three, as well as by giving diets containing lipid [Grigor & Warren (1980) Biochem. J. 188, 61-65]. 2. The specific activities of the lipogenic enzymes fatty acid synthase, glucose 6-phosphate dehydrogenase and ‘malic’ enzyme increased between 6- and 10-fold in the mammary gland and between 2- and 3-fold in the livers during the first 10 days of lactation. The increases in specific activity coupled with the doubling of liver mass which occurred during pregnancy and lactation resulted in considerable differences in total liver activities when compared with virgin animals. 3. Although consumption of a diet containing 20% peanut oil suppressed the activities of the three lipogenic enzymes in the livers, only the ‘malic’ enzyme was affected in the mammary glands. 4. In contrast, decreased milk demand did not affect the specific activities of any of the liver enzymes, whereas it resulted in suppression of all three lipogenic enzymes of the mammary glands. There was no effect on either the cytoplasmic malate dehydrogenase or the lactate dehydrogenase of the mammary gland. 5. In all the experiments performed, the activity of the fatty acid synthase correlated with the amount of material precipitated by the rabbit antibody raised against rat fatty acid synthase.

Oxygen concentration in milk of healthy and mastitic cows and implications of low oxygen tension for the killing ofStaphylococcus aureusby bovine neutrophils

1988 ◽  
Vol 55 (4) ◽  
pp. 513-519 ◽  
Author(s):  
Susan J. Mayer ◽  
Avril E. Waterman ◽  
Peter M. Keen ◽  
Neil Craven ◽  
F. John Bourne
Keyword(s):  
Staphylococcus Aureus ◽  
Mammary Gland ◽  
Partial Pressure ◽  
Oxygen Concentration ◽  
Bactericidal Activity ◽  
Mammary Glands ◽  
Low Oxygen ◽  
Low Oxygen Tension ◽  
Bovine Neutrophils ◽  
Venous Plasma

SummaryThe partial pressure of O2in milk from normal cows and from cows with mastitis was measured and the concentrations of O2calculated. Oxygen levels of milk from normal cows were similar to those in venous plasma, but inflammation of the mammary gland led to a dramatic drop in O2concentration to < 10% of control values. Intracellular survival ofStaphylococcus aureusstrain M60 in bovine neutrophils was greater under anaerobic than aerobic conditions. The implications of low O2concentrations in milk from infected mammary glands for the bactericidal activity of bovine neutrophils is discussed.

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