Objective: Evaluate effect of hyperprolactinemia on breasts conditions.
Methods: Investigated 2 groups of patients with average age 34.9±7.5. The first group is 30 women with hyperprolactinemia. Inclusion criterion was an increase in prolactin level above 1000 mU/l with a double determination, as well as duration of at least 6 month, lack of taking antidepressants and oral contraceptives for last 3 month before the start of study, absence of concomitant endocrine disruption: hypotiroidism, thyrotoxicosis, acromegaly. Clinical examination included anamnesis and determining prolactin, E2, TSH, LH, FSH, hormone levels, MRI-scan of brain with targeted pituitary research, ultrasound diagnosis of breasts, small pelvis, mammography, gynecologist and breast specialist consultation. The second control group includes 18 healthy women. Criteria for inclusion considered normal level of prolactin in double determination, lack of complaints during palpation, lack of lactorhea.The control group is similar to the first group was examined for hormonal and instrumental methods of research.
Results: In the first group level of prolactin ranged from 1005.1 to 8404.6 mU/l. On MRI-scan were identified: macroprolactinomas had 2 woman (6.66%), microprolactinomas had 10 (33.3%), hormonally inactive pituitary adenomas had 4 (13.3%), ETSS had 8 (26.6%), pituitary cystoadenoma had 1 (3.33%), unfundibulum had 1 (3.33%) and no pathology of the pituitary gland had 4 (13.3%). 26 women had colostrum, 4 woman had no discharge from the breast. Lactorhea severity assessed on a scale: 1 degree-single drops when pressed hard (+), 2 degree- abundant (++), 3 degree- spontaneous release of milk (+++). 4 patients had grade 1; 21 patients gad grade 2; 1 patient had grade 3. For results of mammological studies used Rozjkovas classification (1993). In the first group, 13 women had fibrocystic mastopathy (43.3%) 4 woman had- adenosis (13.3%), 5 woman had fibro fatty involution (16.6%) and in the 8 women (26.6%) the structure of breast did not differ from the norm. In women from the control group, fibrocystic mastopathy in 7 patients (38.8%),of which two had adenosis (11.1%), and 3 patients had fibro fatty involution (16.6%) and 6 patients had no deviations (33.3%).
Conclusion: Hyperprolactinemic condition is the result of damage to hypothalamic pituitary area & pituitary gland in 26 patients. Modification of the breast structure in hyperprolactinemic conditions is characterized by fibrocystic mastopathy (60%),fibrofatty involution (16.6%) and adenosis (13.3%). Its necessary to consider the higher level of prolactin, the higher the risk of fibro-fatty involution by 50%. With normalization of prolactin levels, the glandular tissue tends to increase.
18 - 21 May 2019
European Society of Endocrinology