Danazol, antigonadotropin
Danazol, an antigonadotropin derived from 17-ethynyltestosterone, has attracted attention in the treatment of endometriosis and cystic fibrous mastopathy. As in the case of progestogens, the mechanism of its effect on fibrocystic mastopathy is unclear.
It was shown that it reduces some parameters of the functioning of the endocrine system, which can affect the state of the mammary glands.
• Antigonadotropic action – prevents the release of luteinizing hormone in the middle of the menstrual cycle.
• Anti-estrogenic effect – inhibits a number of enzymes involved in the formation of steroids in the ovaries.
Brookshaw described 514 patients with benign breast diseases who received various doses of danazol for 6 months. The author believes that in order to obtain the best results, treatment should be continued for 4-6 months. at a dose of 200-400 mg / day, while the frequency of the complete response is 68%.
The effectiveness of tamoxifen was studied by Ricciardi and Ianniruberto, who prescribed the drug at a dose of 10 mg / day from the 5th to the 25th day of the menstrual cycle for 4 months. The response rate to treatment was 72%.
Some supporters of drug treatment prefer bromocriptine. In Copenhagen, Blichert-Toft et al. conducted a double-blind cross-sectional study in 10 women with diffuse fibrocystic mastopathy. When treating bromocriptine at a dose of 2.5 mg / day during the first week of each menstrual cycle and 5 mg / day for the next 3 weeks. or in placebo, identical in appearance, in 8 out of 10 women the breast pain disappeared completely, and in 2 there was a clear improvement, while only 1 woman showed an improvement in placebo.
Regarding whether women with benign cystic changes in the breast have increased risk of a malignant tumor, opinions differ significantly. Some well-known doctors believe that cystic changes increase the risk of cancer by 2-4 times. Other experts disagree. In the most famous studies, the coexistence of benign changes in the surgical material obtained by mastectomy for breast cancer (BC) was studied. These studies did not reveal a greater frequency of microscopically detectable fibrocystic mastopathy in the mammary glands affected by the tumor, compared with the non-affected glands obtained by necropsy.