Morphological features of benign mammary dysplasia in women with endometriosis-associated infertility
E.N. Vandeeva1, A.E. Protasova1–5, G.A. Raskin2,3, M.I. Yarmolinskaya4,6
1 Almazov St. Petersburg Research Medical Center, Saint Petersburg
2 St. Petersburg State University, Saint Petersburg
3 Granov Russian Research Center of Radiology and Surgical Technologies, Saint Petersburg
4 Mechnikov North-Western State Medical University, Saint Petersburg
5 LLC AVA-PETER, Saint Petersburg
6 Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, Saint Petersburg
Aim: to assess the morphological features in women with benign mammary dysplasia (BMD) with endometriosis-associated infertility.
Patients and Methods: 53 morphological biopsy specimens of BMD in women (from 23 to 40 years) were analyzed. The diagnosis of endometriosis in each patient was morphologically verified. All women in a personal history had primary or secondary infertility. An ultrasound revealed signs of BMD. The diagnosis of BMD was established according to ICD-10. Interpretation and recording of the conclusion about the presence or absence of pathological signs of the MT was carried out using the BI-RADS categories (Breast Imaging Reporting and Data System). Mammography was performed according to indications. A group of women with the category BI-RADS IV underwent a core needle biopsy of the suspicious area under ultrasound control.
Results: in women with endometriosis-associated infertility, fibrosclerosis of the mammary gland (MG) predominated (N60.3) — 29 cases (54.72%). Diffuse cystic form of BMD (N60.1) was diagnosed in 10 patients, which corresponded to 18.87% of cases. Fibroadenosis of BMD (N60.2) was manifested in 5 patients (9.43%). Unspecified form of BMD (N60.9) is represented in 3 (5.66%) cases. Inflammatory diseases of the MG (N61) were diagnosed in 5 patients (9.43%). MG fibroadenoma (D24) was morphologically confirmed in 1 patient (1.89%). A morphological study of the MT revealed the heterogeneity of the BMD forms with the prevalence of fibrosclerosis and diffuse forms of cystic mastopathy.
Conclusion: according to the results of the study, the morphological heterogeneity of BMD in patients with endometriosis-associated infertility was revealed, which is represented by the following forms: MG fibrosclerosis, diffuse cystic form of BMD, fibroadenosis of BMD, unspecified BMD form. The largest rate of BMD in endometriosis-associated infertility is manifested by fibrosclerosis and is of 54.72% of cases. MG fibrosclerosis in women with endometriosis may be due to the lack of differentiation of the MT in connection with unrealized reproductive function.
Key words: endometriosis, endometriosis-associated infertility, benign mammary dysplasia, ultrasound, fibrosclerosis.
For citation: Vandeeva E.N., Protasova A.E., Raskin G.A., Yarmolinskaya M.I. Morphological features of benign mammary dysplasia in women with endometriosis-associated infertility // RMJ. Medical Review. 2018. № 10. P. 22–25.
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2. Bruner-Tran K.L., Herington J.L., Duleba A.J. et al. Medical management of endometriosis: emerging evidence linking inflammation to disease pathophysiology // Minerva Ginecol. 2013. Vol. 65. P. 199–213.
3. Parente Barbosa C., Bentes De Souza A.M., Bianco B., Christofolini D.M. The effect of hormones on endometriosis development // Minerva Ginecol. 2011. Vol. 63(4). P. 375–386.
4. Основные показатели здоровья матери и ребенка, деятельность службы охраны детства и родовспоможения в Российской Федерации. М., 2013. C. 164 [The main indicators of maternal and child health, the activities of the service of protection of children and obstetrics in the Russian Federation. M., 2013. S. 164 (in Russian)].
5. Theobald P., Cottenet J., Iacobelli S., Quantin C. Epidemiology of Endometriosis in France: A Large, Nation-Wide Study Based on Hospital Discharge Data // Biomed Res Int. 2016. Vol. 4. Р. 3260952. DOI: 10.1155/2016/3260952.
6. Robert L. Barbieri Why are there deleys in the diagnosis of endometriosis? // OBG Manag. 2017. Vol. 29(3). P. 10–11.
7. Triolo O., Laganà A. S., Sturlese E. Chronic pelvic pain in endometriosis: an overview // Journal of Clinical Medicine Research. 2013. Vol. 5(3). P. 153–163. DOI: 10.4021/jocmr1288w.
8. Chapron C., Bourret A., Chopin N. et al. Surgery for bladder endometriosis: long-term results and concomitant management of associated posterior deep lesions // Human Reproduction. 2010. Vol. 25(4). P. 884–889. DOI: 10.1093/humrep/deq017.
9. Butticè S., Laganà A.S., Mucciardi G. et al. Different patterns of pelvic ureteral endometriosis. What is the best treatment? Results of a retrospective analysis // Archivio Italiano di Urologia, Andrologia. 2016. Vol. 88(4). P. 266–269. DOI: 10.4081/aiua.2016.4.266.
10. Чернуха Г.Е., Ильина Л.М., Павлович С.В., Адамян Л.В. Глубокий инфильтративный эндометриоз: послеоперационные рецидивы и возможные пути их профилактики // Акушерство и гинекология. 2015. № 8. С. 39–46 [Chernuha G.E., Il’ina L.M., Pavlovich S.V., Adamjan L.V. Glubokij infil’trativnyj jendometrioz: posleoperacionnye recidivy i vozmozhnye puti ih profilaktiki // Akusherstvo i ginekologija. 2015. № 8. S. 39–46 (in Russian)].
11. Филиппова Е.С., Козаченко И.Ф., Быков А.Г. Современный взгляд на овариальный резерв у женщин репродуктивного возраста с эндометриоидными кистами яичников (обзор литературы) // Проблемы репродукции. 2017. Т. 23. № 2. С. 72–80. DOI: 10.17116/repro201723272-80 [Filippova E.S., Kozachenko I.F., Bykov A.G. Sovremennyj vzgljad na ovarial’nyj rezerv u zhenshhin reproduktivnogo vozrasta s jendometrioidnymi kistami jaichnikov (obzor literatury) // Problemy reprodukcii. 2017. № 23(2). S. 72–80. DOI: 10.17116/repro201723272-80 (in Russian)].
12. Ozkan S., Murk W., Arici A. Endometriosis and infertility: epidemiology and evidence-based treatments// Ann N Y Acad Sci. 2008. Vol. 1127. P. 92–100. DOI: 10.1196/ annals.1434.007.
13. Международная статистическая классификация болезней и проблем, связанных со здоровьем (10-й пересмотр). Всемирная организация здравоохранения. М., 1998. C. 2466 [Mezhdunarodnaia statisticheskaia klassifikatsiia boleznei i problem, sviazannykh so zdorov’em (10-i peresmotr). Vsemirnaia organizatsiia zdravookhraneniia. M., 1998. S. 2466 (in Russian)].
14. Uimari О., Järvelä I., Ryynänen M. Do symptomatic endometriosis and uterine fibroids appear together? // J Hum Reprod Sci. 2011. Vol. 4(1). P. 34–38. DOI: 10.4103/0974-1208.82358
15. Ballard K., Seaman H., de Vries C., Wright J. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study. Part 1 // BJOG. 2008. Vol. 115. P. 1382–1391.
16. Farland L.V., Tamimi R.M., Eliassen A.H. et al. A Prospective study of Endometriosis and Risk of Benign Breast Disease // Breast Cancer Res Treat. 2016. Vol. 159(3). P. 545–552. DOI: 10.1007/s10549-016-3957-y.
17. Кулагина Н.В. Доброкачественные заболевания молочных желез: Учебное пособие. 2-е изд., доп. М.: ООО «Типография «Печатных дел мастер», 2012. 64 с. [Kulagina N.V. Dobrokachestvennye zabolevanija molochnyh zhelez: Uchebnoe posobie. 2-e izd., dop. M.: OOO «Tipografija «Pechatnyh del master», 2012. 64 s. (in Russian)].Samoli E., Trichopoulos D., Lagiou A. et al. The hormonal profile of benign breast disease // Br J Cancer. 2013. Vol. 108. P. 199–204. DOI: 10.1038/bjc.2012.493.
18. Russo J., Russo I.H. Role of hormones in human breast development: The menopausal breast. In: Progress in the management of menopause. London: Parthenon Publishing, 1997. P. 184–193.
19. Коган И.Ю., Мясникова М.О., Мусина Е.В. Прогестерон в лечении мастопатии / под ред. академика Э.К. Айламазяна. М.: ООО «Типография «Печатных дел мастер», 2012. 68 с. [Kogan I.Ju., Mjasnikova M.O., Musina E.V. Progesteron v lechenii mastopatii / pod red. akademika Je.K. Ajlamazjana. M.: OOO «Tipografija «Pechatnyh del master», 2012. 68 s. (in Russian)].
20. Alonzo-Sosa J.E., Cárdenas-Bazan M.A., Dávila-Velazquez J. Prevalence of fibrocystic disease of breast in patients with endometriosis // Ginecol Obstet Mex. 1996. Vol. 64. P. 283–285. PMID: 8754730.
21. Дощанова А.М. Гормональная терапия эндометриоза и состояние молочных желез // Вестник Кыргызско-Российского славянского университета. 2015. Т. 15. № 4. С. 32–35 [Doshhanova A.M. Gormonal’naja terapija jendometrioza i sostojanie molochnyh zhelez // Vestnik Kyrgyzsko-Rossijskogo slavjanskogo universiteta. 2015. Vol. 15 (4). S. 32–35 (in Russian)].
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