Analysis of Hormonal Profile in Women with Benign Breast Diseases and Women without Breast Pathology at a Tertiary Care Hospital in Lucknow, India: A Cross-sectional Study

Abstract

Introduction: Disruptions in normal hormonal pathways contribute to the development of various benign breast conditions. Having a general understanding of specific hormonal interactions, such as estradiol, progesterone, and prolactin, among breast tissue, the hypothalamus, the pituitary, and the gonads, can enhance understanding of the causes and manifestations of benign breast conditions such as fibroadenoma, fibroadenosis, breast cyst, abscess, mastitis, galactocele, and phyllodestumour. However, there is limited available information regarding the hormonal environment associated with Benign Breast Disease (BBD). Aim: To compare serum levels of estradiol, progesterone, and prolactin between women with BBD and those without breast pathology. Materials and Methods: This cross-sectional study was conducted in the Department of General Surgery, Era Lucknow Medical College and Hospital (ELMC and H), Lucknow, Uttar Pradesh, India, from January 2021 to January 2023. A total of 80 female subjects were enrolled and divided into two groups: Group A (40 subjects diagnosed with BBD by triple assessment) and Group B (40 subjects with no breast pathology). Serum levels of estradiol, progesterone, and prolactin were tested during the follicular phase and compared between the two groups. Student t-test and Spearman’s correlation with a 95% confidence interval were used for mean comparison between the groups. Receiver Operating Characteristic (ROC) analysis was performed to determine cut-off values, sensitivity, and specificity for the hormones. A p-value of <0.05 was considered as significant. Results: The mean age showed no statistical differences between Group A (26.5 years) and Group B (28.8 years). The mean levels of estradiol and progesterone hormones were significantly higher in Group A (188.38±96.06 pg/mL; 4.34±5.05 ng/mL) than in Group B (103.21±39.52 pg/mL; 0.38±0.30 ng/mL) with a p-value of 0.001. The sensitivity of estradiol was found to be 80% with a specificity of 75% based on ROC analysis when the cut-off was set to <139.5. Furthermore, progesterone showed a sensitivity of 92.50% and specificity of 80% at a cut-off <0.8560. Prolactin showed a sensitivity of 52.50% and specificity of 62.50% at a cut-off <18.96. Conclusion: Authors concluded that steroidal harmones have a significant effect on the development of BBD. The present study had demonstrated that women with BBD exhibit higher levels of estradiol and progesterone compared to women without breast pathology.

Keywords

• endocrine milieu
• hormone dependency of breast diseases
• non malignant breast disease