A prospective study on the role of centchroman in regression of fibroadenoma

Authors

  • Navdeep Kumar Singla Department of Surgery, Government Medical College, Patiala, Punjab
  • Ruby Bhatia Department of Obstetrics and Gynecology, Government Medical College, Patiala, Punjab
  • Renu Verma Department of Surgery, Government Medical College, Patiala, Punjab
  • Suresh Kumar Bhatia Department of Surgery, Government Medical College, Patiala, Punjab

DOI:

https://doi.org/10.18203/2349-2902.isj20214365

Keywords:

Fibroadenoma, Centchroman, Saheli, Non-steroidal, Anti-estrogen, Ultrasonology

Abstract

Background: Fibroadenoma commonly present as painless breast lump in young girls. Nearly 10-15% regress spontaneously over the period of 6-60 months, rest are managed surgically. Centchroman (Saheli), a novel non-steroidal, selective anti-estrogen has been used for the treatment of mastalgia and its effectiveness in the treatment of fibroadenoma is being tested in the ongoing trials.

 Methods: A total of 60 patients between 15-35 years of age with painless lump breast of size 2 to 5 centimeters confirmed as fibroadenoma by fine needle aspiration cytology (FNAC) were included in the study. Detailed patient's characteristics, clinical history, physical examination (for size in 2 dimensions), ultrasound findings (for size in 3 dimensions) were assessed. All participants included in the study were given tablet Centchroman (Saheli) 30 mg thrice weekly orally for 3 months. Size of Fibroadenoma was reassessed clinically for size in two dimensions and ultrasonologically for size in three dimensions at 4 weeks and 3 months of starting of therapy.

Results: Out of 60 patients, 18 patients (30%) had complete response, 40 patients (66.66%) showed a decrease in the size of fibroadenoma and only 2 patients (3.33%) had no response to this therapy. None showed an increase in size.

Conclusions: It may prove to be the most effective modality for the treatment of small sized fibroadenoma breast especially in unmarried girls with minimal side effects. Ultrasonology may be relied upon for follow up measurements since it is more accurate in measuring the dimensions.

References

Dent DM, Cant PJ. Fibroadenoma. World J Surg. 1989;13:706-10.

Hughes LE, Mansel RE, Webster D. Aberrations of normal development and involution (ANDI): A new perspective on pathogenesis and nomenclature of benign breast disorders. Lancet. 1987;2:1316.

Richard C. Sainsbury. The Breast. Bailey and Love’s Short Practice Of Surgery; 24, Boca Raton, FL. 2:834.

Cant PJ, Madden MV, Close PM, Learmonth GM. Case for conservative management of selected fibroadenoma of the breast. Br J Surg. 1987;74:857-9.

Scott-Conner, Carol EH Dirbas, Frederick. Breast surgery office management and surgical techniques. New York: Springer.1. 2010;71.

DAS S. A manual on clinical surgery: including special investigations and differential diagnosis. 3ed.

Archer F, Omar M. The fine structure of fibro-adenoma of the human breast. J Pathol. 1969;99:113.

DeMay M. Practical Principles of Cytopathology (Revised). ASCP press. 2007.

Sitruk-ware LR, Sterkers N, Mowszowicz I, Marvais-Jarvis P. Inadequate corpus Iuteal function of women with benign breast diseases. J Clin Endocrino Metab. 1977;44:771-4.

Kaufman CS, Littrup PJ, Freeman-Gibb. LA Office Based Cryoablation of Breast Fibroadenomas with Long-Term Follow-up. The Breast Journal. 2005;11:344-50.

Ylagan LR. The Washington Manual of Surgical Pathology. 2008;267-9.

Andolf E, Jorgensen C, Svelenius E, Sunden B. Ultrasonographic measurement of ovarian volume. Acta Obstet Gynecol Scand. 1987;66:387-9.

Mansel RE. Benign breast disease. Practitioner. 1992;236:830-7.

Singh MM. Centchroman, a selective estrogen receptor modulator as a contraceptive and for the management of hormone related clinical disorders. Med Res Rev. 2001;21:302-34.

Krishnaswamy U. Profile of benign breast disorders and diseases in urban India. Indian J Surg. 2003;65:178-81.

Dhawan BN, Srimal RC. Anti-inflammatory and some other pharmacological effects of 3, 4-trans-2, 2-dimethyl-3-phenyl-4-{B-pyrrolidinoethoxy)-phenyl}-7-methoxy-chroman (Centchroman). Br J Pharmocol. 1973;49:64-73.

Giri AK, Mukhopadhyay A, Sun J, Hsie AW, Ray S. Anti-mutagenic effects of Centchroman - a contraceptive and a candidate drug for breast cancer in multiple mutational assays. Mutagenesis. 1999;14:613-9.

Nelson Z, Ray Rm, Gao Dl, Thomas DB. Risk factors for fibroadenoma in a cohort of female textile workers in Shanghai, China. Am J Epidemiol. 2002;1:599-605.

Thomas L, Asad M, Hrishikeshavan HJ, Chandrakala GK. Effect of Centchroman on cellular and humoral immunity. Indian Journal of Physiology and Pharmacology. 2007;51:387-94.

Esteveo RA, Nazario AC, Baracat EC. Effect of Oral contraceptives with and without associated estriol on ultrasound measurements of breast fibroadenoma: randomised clinical trial. Sao Pailo Med J. 2007;125:275-80.

Dhar A, Srivastava A. Role of Centchroman in Regression of Mastalgia and fibroadenoma. World J Surg. 2007;31:1178-84.

Tejwani PL, Srivastava A. Regression of Fibroadenomas with Centchroman: a Randomized Controlled Trial. Indian J Surg. 2015;77:484-9.

Gupta N. A Prospective Study to study the Efficacy and Side Effects of Ormeloxifene in Regression of Mastalgia and Fibroadenoma: Is It the Ideal Drug?. J South Asian Feder Obst Gynae. 2016;8:48-56.

Sharma B, Narayan S, Sharma N, Parmar A. Centchroman Regress Mastalgia and Fibroadenoma: An Institutional Study. Journal of Medical Science and Clinical Research. 2016;04:11334-9.

Dhar D, Ghosh P, Mukherjee SK, Paira SK, Mukherjee R, Halder SK. A Comparative Study Of Centchroman Vs Danazol Vs Evening Primrose Oil In The Management Of Mastalgia And Fibroadenoma. International Journal Of Scientific Research. 2017;6:149-51.

Balamurugan C, Vignesh M, Princess Beulah D, Sabarmalai P. Regression of Fibroadenoma In Response To Centchroman Therapy- A Randomized Control Trial. Stanley Medical Journal. 2017;4:19-22.

Shelly W, Draper MW, Krishnan V, Wong M, Jaffe RB. Selective estrogen receptor modulators: An update on recent clinical findings. Obstetrical & Gynecological Survey. 2008;63:163-81.

Dhananjay BS, Nanda SK. The Role of Sevista in the Management of Dysfunctional Uterine Bleeding. Journal of Clinical And Diagnostic Research. 2013;7:132-4.

Ravibabu K, Palla J, Chintadas GS. A Study of Efficacy of Ormeloxifene in the Pharmacological Management of Dysfunctional Uterine Bleeding. Journal of Clinical and Diagnostic Research. 2013;7:2534-6.

Kriplani A, Srivastava A, Kulshrestha V. Efficacy of ormeloxifene versus oral contraceptive in the management of abnormal uterine bleeding due to uterine leiomyoma.. The Journal of Obstetrics and Gynaecology Research. 2016;42:1744-52.

Downloads

Published

2021-10-28

Issue

Section

Original Research Articles