Pathogenetic therapy of benign breast dysplasia

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Objective: To evaluate mammographic breast density and determine the relationship of breast density in terms of synergy of radiation diagnostics and long-term pathogenetic therapy (6 months) with indolcarbinol medication in patients with benign breast dysplasia and mastodynia.

Materials and methods: The study included the results of the retrospective analysis of the data obtained from 2500 patients aged 20 to 59 years diagnosed with benign breast dysplasia. All the patients were examined and treated at the Russian Scientific Center of Roentgen Radiology, Moscow from 2021 to 2024. The evaluation of the patients’ condition included clinical examination, pain assessment using visual analog scale and instrumental studies (mammography, color Doppler ultrasonography and elastography, MRI with contrast agents) depending on the age and indications for the study. The results of instrumental examinations were evaluated according to the Breast Imaging-Reporting and Data System (BI-RADS) classification on a scale from 1 to 5, including tissue density assessment by the ACR classification (for mammography). The evaluation of the hormonal status and the concomitant diseases of the organs of the female reproductive system was carried out by a gynecologist. The results of the study showed that there were 250 patients with high tissue density, mastalgia and concomitant diseases of the reproductive organs; they were recommended therapy with indolcarbinol (Indinol Forto medication), namely one capsule twice a day for six months.

Results: Mastodynia/mastalgia disappeared in 140/250 (56%) women after six months of taking Indinol Forto. The condition stabilized (mastalgia and mastodynia were absent) in 198/250 (79.2%) patients one year after treatment. There was a one-point decrease in BI-RADS category 6 months after treatment with Indinol Forto in 18% of cases (change of category 3 BI-RADS to category 2 BI-RADS in 7.2% of cases, and category 2 BI-RADS to category 1 BI-RADS in 10.8% of cases); the assessment of tissue density type using the ACR classification showed changes after treatment from type D to type C, and from type C to type B in 25% of cases.

Conclusion: Indinol Forto is an effective medication for the treatment of benign breast dysplasia and can be recommended as a first-line treatment for cyclic mastalgia.

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作者简介

Elena Meskikh

Russian Scientific Center of Roentgen Radiology, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

编辑信件的主要联系方式.
Email: meskihelena@rambler.ru

Dr. Med. Sci., Professor of the Department of X-ray Radiology; doctor of the highest category, Chief Researcher at X-ray Radiological Laboratory

俄罗斯联邦, Moscow; Moscow

Lev Ashrafyan

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: levaa2004@yahoo.com
ORCID iD: 0000-0001-6396-4948

Academician of the Russian Academy of Sciences, Professor, Dr. Med. Sci., Head of the Institute of Oncogynecology and Mammology

俄罗斯联邦, Moscow

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2. Fig. 1. Assessment of density according to the ACR scale (the percentage of fibroglandular tissue to fat is given in brackets)

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3. Fig. 2. Density by ACR (mammography)

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4. Fig.3. Evaluation of instrumental methods according to B-IRADS

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5. Fig. 4. Clinical example of hereditary breast cancer in patient K., born in 1987. Mammograms of the mammary glands: against the background of glandular tissue (high radiographic density) in the left mammary gland on the border of the lower quadrants, an area of ​​local strand reorganization of the structure measuring 12x10 mm is determined. Ultrasound examination of the mammary glands (B-mode and elastography): in the left mammary gland on the border of the lower quadrants, an irregularly shaped formation measuring 8x4 mm is determined, vertically oriented, with unclear outlines. Histological examination: infiltrating ductal carcinoma G3; immunohistochemical examination: luminal type B HER 2 negative BRCA1+

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6. Fig. 5. Assessment of pain syndrome before and after treatment

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7. Fig. 6. B-IRADS score before and after treatment

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8. Fig. 7. Changes in tissue density on mammograms according to ACR before and after treatment

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9. Fig. 8. Clinical example of the effect of long-term pathogenetic therapy with Indinol Forte on changes in tissue density in patient K., born in 1985, with a diagnosis of: Fibrocystic mastopathy (N60.1), B-IRADS 2, with severe mastalgia

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