Endocrinological Profiles in Benign Breast Disease

Abstract

The structural and pathological changes that occur in the human female breast are often labelled as benign breast disease (BBD), although it is evident that many of the changes are in fact aberrations of normal development and involution. Since these developmental and involutional changes are under direct hormonal control, it would be expected a priori that BBD would be related to hormonal changes. There are certainly epidemiological correlations between BBD and oral contraceptive use and obesity, both being protective [3]. Also a previous history of both benign and malignant breast disease and small breast size increase the risk of subsequent benign breast biopsy [15]. Further circumstantial evidence of a hormonal aetiology is suggested by the fact that conditions such as fibroadenoma and cystic disease occur in age ranges that correspond with particular phases of ovarian function. Despite these epidemiological associations and the development of accurate estimations of hormones by radioimmunoassay, a clear abnormality of any single hormone has not been found in patients with BBD. One of the major difficulties in all the studies published is the definition of the term “BBD”. The condition is very heterogeneous and different terms are used to describe the same patient group in different countries. The endocrine defect, if it exists, is likely to be subtle and may only be present in certain subgroups of BBD. Many of the published studies do not describe their BBD patients accurately and so it is not possible to know whether the patients have been diagnosed by clinical examination alone or by pathology after a biopsy. Further methodological problems have been caused by assay differences and sampling differences between studies. It is therefore not surprising that no definite reproducible defect has been demonstrated in most cases of BBD.