Репродуктивная эндокринология (Mar 2023)
Possibilities of multi-parameter ultrasonography in diagnostic and evaluation of Vitex agnus-castus treatment of patients with mastodynia and mastopathy
Abstract
Objectives: 1) to determine the elasticity of normal breast tissue (parenchyma and premammary adipose tissue) in healthy women using ultrasound two-dimensional shear wave elastography (2D-SWE); 2) to reveal a possible correlation between increased stiffness of the breast parenchyma and hyperprolactinemia in patients with mastodynia and mastopathy; 3) to evaluate the ability of the Vitex agnus-castus drug to reduce the stiffness of the breast glandular tissue; 4) to objectify the ability of the Vitex agnus-castus drug to affect the thickness of the breast parenchyma, the condition of the milk ducts and cystic changes. Materials and methods. Breast tissue stiffness was investigated using 2D shear wave elastography (2D-SWE) in 32 women aged 18–52 with cyclic mastalgia/mastopathy before and after treatment with Vitex agnus-castus drug. A correlation was made with laboratory parameters (prolactin level), the general condition of the breast according to the results of ultrasonography in gray scale mode. The control group consisted of 78 women without complaints, without signs of diffuse and focal pathology of the mammary glands. Results. The 2D-SWE elastography showed normal values of breast tissue stiffness in women without pathology. 2D-SWE in symptomatic women made it possible to detect increased stiffness of the breast parenchyma, thereby screening for its diffuse changes. At the same time, dynamic changes in the softbreast tissue as a result of the treatment (parenchyma thickness, dilatation of the milk ducts, the presence of simple cystic foci (BI-RADS 2)) were diagnosed, analyzed and compared in grayscale mode ultrasonography (2D). The majority of patients (90,6%) noted a decrease in the level of prolactin after treatment. Statistical evidence of the positive effect of the Vitex agnus-castus drug in the treatment of mastodynia/mastopathy has been proven. Conclusions. Assessment of the basic breast tissue stiffness using 2D-SWE makes it possible to screen patients with its elevated values. This fact makes it possible to assign these women to the risk group of developing breast cancer. Evaluation of changes in the mechanical stiffness properties of the breast soft tissues makes it possible to evaluate and objectify the effectiveness of the treatment.
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