Positive association between progestins and the evolution of multiple fibroadenomas in 72 women

Abstract

Objective: Multiple fibroadenomas (MFA) of the breast is a rare benign dis ease, thus its natural history is poorly understood. The aim of our study was to describe the radiological evolution of MFA and to evaluate the influence of d ifferent factors on this evolution. Methods: This was a longitudinal cohort study. All patients included had two clinical and radiological assessments (breast ultrasound (US) and/or MRI) at least 5 years apart. Results: Seventy-two women were followed for 7.6 ± 2.1 years. The radiological evolution showed a decrease or stability in the number of fibroadenomas (F A) in 26/44 cases on the MRI and in 38/64 cases on the US. There was a decrease of size in 35/44 cases on the MRI and in 53/64 cases on the US. An increase in the number of FAs was found in 18/44 cases in the MRI and 26/64 cases in the US with, for the majority, a decrease of size (19/26 by MRI and 16/18 by MRI). Older age at the first FA (P < 0.0001) and at the diagnosis of MFA (P < 0.0001), pregnancy (P = 0.003) and progestin use (P < 0.001), particularly lynestrenol (P < 0.0001), had a beneficial effect on the evolution of MFA. Conclusion: This is the first longitudinal study describing women with MFA. The radiological evolution of MFA seamed favorable and similar to that expected for a single FA. We identified factors influencing the evolution of the disease, incl uding progestin treatments such as lynestrenol, which could have a beneficial effect. Our co hort should be followed further in order to expand our knowledge of MFA, especially concerning the risk of breast cancer.

Keywords

• fibroadenomas
• progestins
• contraception
• pregnancy
• breastfeeding