Avaliação da atividade proliferativa do epitélio mamário durante o 4o mês de uso de anticoncepcional hormonal combinado oral em regime estendido

• Ano de defesa: 2020
• Autor(a) principal: Berrettini Junior, Anastasio [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Hormonal Contraceptives; Anticoncepcional Hormonal
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=10092147; https://hdl.handle.net/11600/64810

Background Oral combined contraception (OCP) is the most widely used contraceptive method in many countries. The evaluation of side effects of OCP has been the subject of studies since its use in 1960, highlighting the effect on breast tissue. By assessing the proliferation rate by measuring Ki-67 by immunohistochemistry, we can establish the action of OCP on breast tissue and the potential relationship between its use and the risk of developing breast cancer. Objective Evaluate the proliferative action of AHCO containing 30 μg of ethinyl estradiol and 150 μg of levonorgestrel used for 3 months extended on the epithelium, by determining Ki-67. It is an arm of a thematic study of the effect of OCP on the mammary epithelium. We compared these results with patients who used the same formulation for 3 months with a break and also, we compared with a group of women with a natural cycle. Material and Methods: 18 patients were included between 18 and 35 years old, with benign breast lump who used OCP. This group underwent resection of the lump and surrounding normal breast tissue, and Ki-67 was evaluated in the latter tissue. As secondary objectives, we compared the result with a historical group of 40 women in which the weekly Ki-67 was determined in a natural cycle and was also compared with a group of 5 women who used the same OCP for 3 months, with pause. Results In the control group, during the natural cycle, the Ki-67 index is elevated at 2 and 4 weeks (3.89 ± 3.32 and 5.39 ± 4.06 respectively) and lower at 1 and 3 weeks (1.10 ± 0.67 and 2.72 ± 2.47 respectively). The extended regime of OCP use showed Ki-67 elevation at the fourth month of use (7.05 ± 3.231). However, this proliferation rate was lower when compared to the group that used 3 months of AHCO with pause (16.69 ± 4,17). Conclusion Despite promoting an increase in mammary epithelial proliferation, OCP used without pause showed a lower rate when compared with users of OCP with pause, indicating that the use without pause may lead to less proliferation of breast tissue.