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Obstetrics and Gynegology2021№12
The breast and sex hormones

The breast and sex hormones

DOI
https://dx.doi.org/10.18565/aig.2021.12.58-66

Smetnik A.A., Rodionov V.V., Kometova V.V., Burmenskaya O.V., Dardyk M.V., Sencha A.N., Ermakova E.I., Ashrafyan L.A.

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russia
The breast is part of a woman’s reproductive system, a target organ for sex hormones, and a site of their local biosynthesis and metabolism. The risk of breast cancer (BC) in the presence of fibrocystic disease largely depends on the severity of breast tissue proliferative processes. Combined oral contraceptives (COCs) have some effect on the breast, which is usually levelled off by other positive effects of this type of therapy. The possible increase in BC risk, which is associated with menopausal hormone therapy (MHT), is small and similar to or lower than that related to decreased physical activity, obesity, and alcohol use. Micronized progesterone or dydrogesterone, as well as tibolone, bazedoxifene, and estrol, which are used in the therapy of menopausal disorders, may be associated with a lower BC risk. A family history of BC is not a contraindication to MHT. BRCA1/2 mutation carriers may benefit from MHT after risk-reducing salpingo-oophorectomy. BC is a contraindication to combined hormonal contraceptives, MHT, tibolone, and local hormone therapy.
Conclusion: Thus, thorough breast examination before and during therapy, selection of patients from the low-risk BC group, and choice of drugs without proven significant effect on BC risks are the key when prescribing COCs or MHT.

Keywords

breast
fibrocystic disease
mastopathy
breast cancer
sex hormones
estrogens
progestogens
androgens
combined oral contraceptives
menopausal hormone therapy
BRCA1/2 gene mutations
Full text (in Russian)

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Received 08.12.2021

Accepted 15.12.2021

About the Authors

Antonina A. Smetnik, MD, Ph.D., Head of the Department of Gynecological Endocrinology, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, +7(495)531-44-44, a_smetnik@oparina4.ru, https://orcid.org/0000-0002-0627-3902,
117997, Russia, Moscow, Ac. Oparina str., 4.
Valery V. Rodionov, Dr. Med. Sci., Head of the Department of Breast Pathology, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, +7(495)531-44-44, v_rodionov@oparina4.ru, https://orcid.org/0000-0003-0096-7126,
117997, Russia, Moscow, Ac. Oparina str., 4.
Vlada V. Kometova, MD, Ph.D., Head of the Department of Oncopathology, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, +7(495)531-44-44, v_kometova@oparina4.ru, https://orcid.org/0000-0001-9666-6875,
117997, Russia, Moscow, Ac. Oparina str., 4.
Olga V. Burmenskaya, Dr. Bio. Sci., Head of the Laboratory of Oncological Genetics, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, +7(495)438-22-92, o_bourmenskaya@oparina4.ru, https://orcid.org/0000-0003-2842-3980,
117997, Russia, Moscow, Ac. Oparina str., 4.
Maria V. Dardyk, MD, Researcher at the Department of Oncopathology, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, +7(495)531-44-44, m_dardyk@oparina4.ru, https://orcid.org/0000-0002-4489-7660,
117997, Russia, Moscow, Ac. Oparina str., 4.
Alexander N. Sencha, Dr. Med. Sci., Professor, Head of the Department of Visual Diagnostics, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, +7(495)531-44-44, a_sencha@oparina4.ru, https://orcid.org/0000-0002-1188-8872,
117997, Russia, Moscow, Ac. Oparina str., 4.
Elena I. Ermakova, MD, Ph.D., Senior Researcher at the Department of Gynecological Endocrinology, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, +7(495)531-44-44, e_ermakova@oparina4.ru, https://orcid.org/0000-0002-6629-051X,
117997, Russia, Moscow, Ac. Oparina str., 4.
Levon A. Ashrafyan, Dr. Med. Sci., Professor, Academician of the RAS, Head of the Institution of Oncogynecology and Mammology, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, +7(495)531-44-44, l_ashrafyan@oparina4.ru,
https://orcid.org/0000-0001-6396-4948, 117997, Russia, Moscow, Ac. Oparina str., 4.

Authors’ contributions: Smetnik A.A., Rodionov V.V., Kometova V.V. – development of the concept and design of a review of publications on the topic of the article, data analysis, writing the text of the manuscript, approval of the manuscript for publication; Burmenskaya O.V., Dardyk M.V., Sencha A.N., Ermakova E.I., Ashrafyan L.A. – a review of publications on the topic of the article, data analysis.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has been partially sponsored within the framework of the state assignment “Assessment of the individual risk of breast cancer in women with benign breast diseases (fibrocystic disease)” (State Registration No. R&D 121040600432-9).
For citation: Smetnik A.A., Rodionov V.V., Kometova V.V., Burmenskaya O.V., Dardyk M.V., Sencha A.N., Ermakova E.I., Ashrafyan L.A. The breast and sex hormones.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 12: 58-66 (in Russian)
https://dx.doi.org/10.18565/aig.2021.12.58-66

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