Mastopathie und Mammakarzinom: Besteht ein typisches Hormonprofil?

Abstract

Carcinoma of the breast and mastopathy are statistically correlated with the functioning of the gonads. The authors studied whether in 58 women with carcinoma of the breast and in 36 patients with mastopathy any change was seen in the secretory pattern of gonadal steroids and whether there were any latent changes in the secretion of prolactin and TSH. A group of 43 women with benign gynaecological diseases served as controls. Before making the diagnosis via immediate section for microscopic examination we determined the basal values of prolactin, LH, FSH, TSH and the oestrogen fractions E1, E2, E3, total oestrogens and progesterone. In addition, we measured the increase in prolactin and TSH after stimulation with metoclopramide. Postoperatively this was followed by measuring the basal values of prolactin and TSH and their secretory performance in respect of TRH. All histological diagnoses were made by an experienced pathologist. Examinations were performed under strictly standardised conditions, taking into account stress, circadian variation and the nutritional status. The following group-specific significant results were obtained (p less than 0.05-0.01): Mastopathy: high serum values of all oestrogen fractions and of total oestrogens, high PRL release through MTC stimulation, prolactin secretory effect after MTC in accordance with the degree of severity of epithelial proliferation, early onset of menopause. Carcinoma of the breast: Low PRL and TSH release on MTC stimulation, low progesterone concentrations during the second cycle phase, relatively high serum concentrations of oestradiol during the first cycle phase, PRL basal values increased postoperatively, compared with preoperative values. The results led to the following conclusions: In mastopathy patients there is a connection between high oestrogen concentrations and consecutively high prolactin release. The morphological substrate is represented by an enhanced proliferation of epithelium. In patients with cancer of the breast reduced progesterone concentrations during the second half of the cycle lead us to suspect an increased incidence of luteal insufficiency; in addition, it appears that the daily prolactin secretion rate in this group is on a reduced level.