Estevão Rodrigo Augusto Fernandes, Nazário Afonso Celso Pinto, Baracat Edmund Chada
Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2007 Sep 6;125(5):275-80. doi: 10.1590/s1516-31802007000500005.
Fibroadenomas are the most common benign tumors of the female breast. The aim of this study was to evaluate the proliferative activity of breast fibroadenoma as shown by ultrasound measurements, following administration of oral contraceptives with and without associated estriol.
This was a randomized, double-blind, placebo-controlled clinical trial carried out in the Mastology Sector, Department of Gynecology, Universidade Federal de São Paulo.
We studied 33 women with fibroadenomas. Ten were placed in group 1 and took an oral contraceptive consisting of levonorgestrel and ethinyl estradiol together with placebo material in the same capsule, for four consecutive cycles with a seven-day interval between them. The other 23 patients constituted group 2 and took the oral contraceptive as above together with estriol in the same capsule, in the same way as done by the group 1 patients. We took ultrasound measurements of their tumors (in three dimensions) before and after the intake of medication. At the end of the study, all the patients had their tumors removed by surgery.
We observed decreased fibroadenoma width among the users of oral contraceptives with placebo, and this decrease was statistically significant. In the other group, we did not observe any changes (in width, length or height).
The results confirm that estriol may block the protective effect of oral contraceptives on fibroadenomas, since we observed decreased fibroadenoma width among the group 1 patients but not the group 2 patients.
纤维腺瘤是女性乳腺最常见的良性肿瘤。本研究旨在评估口服含或不含雌三醇的避孕药后,超声测量所示乳腺纤维腺瘤的增殖活性。
这是一项在圣保罗联邦大学妇科乳腺科进行的随机、双盲、安慰剂对照临床试验。
我们研究了33例患有纤维腺瘤的女性。10例被纳入第1组,连续四个周期服用含左炔诺孕酮和炔雌醇的口服避孕药,且同一胶囊中含有安慰剂,周期之间间隔7天。另外23例患者构成第2组,服用与第1组患者相同的口服避孕药,且同一胶囊中含有雌三醇。在服药前后对她们的肿瘤进行超声三维测量。研究结束时,所有患者均通过手术切除肿瘤。
我们观察到服用含安慰剂口服避孕药的患者纤维腺瘤宽度减小,且这种减小具有统计学意义。在另一组中,我们未观察到任何变化(宽度、长度或高度)。
结果证实雌三醇可能会阻断口服避孕药对纤维腺瘤的保护作用,因为我们在第1组患者中观察到纤维腺瘤宽度减小,而在第2组患者中未观察到。