Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press60310.17650/1994-4098-2018-14-3-19-24MAMMOLOGY. ORIGINAL REPORTSМАММОЛОГИЯ. ОРИГИНАЛЬНЫЕ СТАТЬИThe effect of Metformin on fibrocystic breast disease in women with insulin resistanceВлияние метформина на течение фиброзно-кистозной мастопатии у женщин с инсулинорезистентностьюhttps://orcid.org/0000-0002-7671-0637MusinaE. V.МусинаЕ. В.
Russian Federation

3 Mendeleevskaya liniya, Saint-Petersburg 199034

199034 Санкт-Петербург, Менделеевская линия, 3

E.musina@mail.ruhttps://orcid.org/0000-0002-7351-6900KoganI. Y.КоганИ. Ю.
Russian Federation

3 Mendeleevskaya liniya, Saint-Petersburg 199034

199034 Санкт-Петербург, Менделеевская линия, 3

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. OttФГБНУ «НИИ акушерства, гинекологии и репродуктологии им. Д.О. Отта»1610201814319241510201815102018https://ojrs.abvpress.ru/ojrs/article/view/603

A little studied question is the development mechanism, timely diagnostics, treatment and prevention of the fibrocystic breast disease at patients with insulin resistance. One of the possible perspective directions of pathogenetic impact on tissues of a mammary gland at the mastopathy associated with a giperinsulinemiya and insulin resistance is use of metformin. Now clinical trials on use of metformin at cancer of mammary glands continue. Data on use of medicines of this group at patients with fibrocystic breast disease in domestic and foreign literature are absent. Objective: assessment of influence of metformin on clinical displays of fibrocystic breast disease and ultrasonic characteristics of a parenchyma of mammary glands at patients with insulin resistance.Materials and methods. As therapy of fibrocystic breast disease patients received metformin in a dose of 1500 mg a day. Dynamic control of a clinical picture of a disease and ultrasonic indicators of a parenchyma of a mammary gland carried out in 3 and 6 months from the beginning of therapy. Results and conclusion. In 6 months of therapy there was a reliable decrease in frequency of a mastalgiya, change of an ultorasound picture of mammary glands: echogenicity of a parenchyma of mammary glands – became sredeny in 95,9% of cases, there was a reliable reduction of thickness of a parenchyma of mammary glands (from 15.5 mm to 10. 5 mm) and diameter of lacteal channels (from 1.7 mm to 0.9 mm). The obtained data on positive influence of metformin on the clinical course of mastopathy and structural changes of a parenchyma of mammary glands at patients with fibrocystic breast disease and insulin resistance allow to consider similar approach as the perspective direction of pathogenetic influence at such pathological association.

Малоизученными остаются вопросы механизма развития, своевременной диагностики, лечения и профилактики фиброзно-кистозной мастопатии (ФКМ) у больных с нарушениями углеводного обмена. Одним из возможных перспективных направлений патогенетического воздействия на ткани молочной железы при мастопатии, ассоциированной с гиперинсулинемией и инсулинорезистентностью, является применение метформина. В настоящее время продолжаются клинические исследования по применению метформина при раке молочной железы. Данные об использовании препаратов данной группы у пациенток с ФКМ в отечественной и зарубежной литературе отсутствуют. Цель исследования – оценка влияния метформина на клинические проявления мастопатии и ультразвуковые характеристики паренхимы молочных желез у пациенток с инсулинорезистентностью. Материалы и методы. В качестве терапии ФКМ пациентки получали метформин в дозе 1500 мг/сут. Динамический контроль клинической картины заболевания и ультразвуковых показателей паренхимы молочной железы осуществляли через 3 и 6 мес от начала терапии. Результаты и заключение. Через 6 мес терапии произошли достоверное снижение частоты масталгии, изменения ультразвуковойкартины молочных желез: эхогенность паренхимы молочных желез стала средней в 95,9 % случаев, отмечено достоверное уменьшение толщины паренхимы молочных желез (с 15,5 до 10,5 мм) и диаметра млечных протоков (с 1,7 до 0,9 мм). Полученныеданные о положительном влиянии метформина на клиническое течение мастопатии и структурные изменения паренхимы молочных желез у пациенток с мастопатией и инсулинорезистентностью позволяют рассматривать подобный подход в качестве перспективного направления патогенетического воздействия при такой патологической ассоциации.

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