L.I. MALTSEVA¹, Yu.V. GARIFULLOVA², M.G. KALINKINA³

¹¹KSMA – Branch Campus of the FSBEI FPE RMACPE MOH Russia, 36 Butlerov Str., Kazan, Russian Federation, 420012

²Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

³Tatarstan Cancer Center, 29 Sibirskiy Trakt, Kazan, Russian Federation, 420029

  Maltseva L.I. ― D. Sc. (medicine), Professor, Head of the Department of Obstetrics and Gynecology №1, e-mail: laramalc@mail.ru

Garifullova Yu.V. ― Assistant of the Department of Obstetrics and Gynecology №1, e-mail: gamil.garifullov@yandex.ru

Kalinkina M.G. ― Senior resident doctor of the Dispensary Department, e-mail: pilulkakzn@gmail.com, ORCID: 0000-0001-9202-9940

Topicality of the research. Mastopathy is the most common benign breast disease in women of reproductive age, creating an unfavorable background for the development of breast cancer. High-density mammary glands are a warning sign detected mammographically. The relationship between breast cancer and low levels of vitamin D in blood was established.

The research objective was to investigate the vitamin D supply in women with benign breast diseases and to assess the effectiveness of the vitamin D treatment of patients with diffuse mastitis according to the dynamics of X-ray mammography.

Results. Patients with benign breast diseases (n=134) show high frequency (66.3%) of vitamin D (VD) deficiency compared to healthy women (7.3%, n=124). Mammographic examination of patients with diffuse mastopathy revealed high density of the breast in every second patient.  It was found that the high density of breast has a negative correlation with the level of VD and the increase of prolactin level in blood. All patients with a level of VD below 30 ng/ml were prescribed treatment with cholecalciferol at a therapeutic dose of 5000 IU per day for 1-2 months, then a maintenance dose of 2000 IU, a course of up to 6 months. Correction of concomitant deficiency of VD within 6 months led to a decrease in the radiological density of the mammary glands and a decrease in the blood prolactin levels when reaching the level of VD not less than 43 ng/ml.

Key words: mastopathy, provision with vitamin D, prolactin (luteotropic hormone), treatment of mastopathy, breast cancer.

(For citation: Maltseva L.I., Garifullovna Yu.V., Kalinkina M.G. Role of vitamin D in reducing breast density in women with diffuse mastopathy. Practical Medicine. 2018)

REFERENCES

1. Ashbeck E.L., Rosenberg R.D., Stauber P.M. et al. Benign breast biopsy diagnosis and subsequent risk of breast cancer. Cancer Epidemiol. Biomarkers Prev, 2007, no. 16 (3), rr. 467-472.
2. Eliassen A.H., Warner E.T., Rosner B., et al. Plasma 25 Hydroxyvitamin D and Risk of Breast Cancer in Women Followed over 20 Years. Cancer Res, 2016, 76 (18), pp. 5423-30.
3. Podzolkova N.M., Sumyatina L.V., Mokhova Yu.A. Prolactin and mammary glands. New data from randomized trials. Akusherstvo i ginekologiya, 2015, no. 12, pp. 46-50 (in Russ.). Bibl. 38 nazv.
4. Shchepotin I.B., Zotov A.S., Lyubota R.V. et al. The clinical significance of breast cancer stem cells (literature review). Opukholi zhenskoy reproduktivnoy sistemy, 2014, no. 3, pp. 14-19 (in Russ.).
5. Melikhova V.S. Creating a functional breast tissue from a single stem cell. Geny i kletki, 2006, vol. 1, no. 1, pp. 21-22 (in Russ.).
6. Thiery J.P., Acloque H., Huang R.Y., Nieto M.A. Epithelial-mesenchymal transitions in development and disease. Cell, 2009, 139, pp. 871-890.
7. Klevebring D., Rosin G., Ma R. et al. Sequencing of breast cancer stem cell populations indicates a dynamic conversion between differentiation states in vivo. Breast Cancer Res, 2014, vol. 16, r72.
8. Angelucci C., Maulucci G., Lama G. et al. Epithelial-stromal interactions in human breast cancer: effects on adhesion, plasma membrane fluidity and migration speed and directness. PLoS One, 2012, 7, p. e50804.
9. Sotnikova L.S., Golubyatnikova E.V. On the question of the effectiveness of therapy for benign breast pathology. Ehffektivnaya farmakoterapiya, 2016, no. 31, pp. 12-18 (in Russ.). Bibl.: 20 nazv.
10. Kundu J.K., Surh Y.J. Emerging avenues linking inflammation and cancer. Free Radic. Biol. Med, 2012, vol. 52, no. 9, pp. 2013-2037.
11. Koli K., Keski-Oja J. 1alpha,25-dihydroxyvitamin D3 and its analogues down-regulate cell invasion-associated proteases in cultured malignant cells. Cell Growth Differ, 2000, no. 11, rr. 221-229.
12. Lundqvist J., Kirkegaard T., Laenkholm A.V., et al. Williams syndrome transcription factor (WSTF) acts as an activator of estrogen receptor signaling in breast cancer cells and the effect can be abrogated by 1α,25-dihydroxyvitamin D(3). J. Steroid Biochem. Mol Biol., 2017, Jun 10. pii: S0960-0760(17)30154-1.
13. Lopes N., Sousa B., Martins D. et al. Alterations in Vitamin D signalling and metabolic pathways in breast cancer progression: a study of VDR, CYP27B1 and CYP24A1 expression in benign and malignant breast lesions. BMC Cancer, 2010, 10, p. 483.