Estrogen and Progesterone Receptors in Fibroadenoma in Response to Centchroman — a Selective Oestrogen Receptor Modulator (SERM)

The fibroadenoma is considered as a manifestation of aberration in normal development and involution (ANDI); however, its exact etiopathogenesis is poorly understood. We investigated the role of oestrogen (ER) and progesterone receptors (PR) in Fibroadenoma, to assess the ER and PR expression in epithelium and stroma of fibroadenoma and to co-relate this expression with the response to centchroman therapy. Fifty ladies with 65 fibroadenomas were investigated. Tissue from core biopsy of lesions was stained for estimating the ER and PR expression in the epithelial cells and in stroma. Patients received tablet centchroman 30 mg daily for 3 months, and the response to therapy was evaluated. A regression ≥ 30% in largest dimension of fibroadenoma on sonography was considered a significant response. The association between the response and ER and PR expression in epithelium and stroma was assessed. In the epithelium: ER positivity = 62.5%; PR positivity = 93.75%. In the stroma, the ER positivity = 2% and PR positivity = 8.3%. Response to centchroman was observed in 33/48 = 68.7%. Among the 33 responders, 23 lesions expressed ER in epithelium, while 10 lesions were ER negative. The relative risk of regression with “ER positivity of epithelium” as exposure = 1.38 (95% CI; 1.35–1.40, p = 0.12). Among responders, 30/33 exhibited PR positivity in epithelium. Expression of ER and PR in the epithelium of fibroadenoma is associated with significant regression in size with 3 months of therapy with centchroman.