Centchroman an annti oestrogenic agent works well in beningn oestrogen sensitive Breast tumour & Fibroademoa(hyperplasia)

ABC of fibroadenoma of breast:-Fibroadenoma is a common cause of discrete, firm, and mobile lump in the breast in young girls between ages 15 and 25 years. It is considered an “aberration in development and involution” of ductolobular tissue in the breast and not a true neoplasm .Fibroadenoma begins as hyperplasia of the lobules from “terminal ductal lobular units” which progressively increases in size from 1cm  to 3 cm . Most of them remain static, but some increase in size to more than 5 cm when they are named “giant fibroadenoma”. Multiple fibroadenomatas can occur in the same breast or bilaterally. Nearly 10–15 % of lesions regress spontaneously over the period of 6 to 60 months. Fibroadenomas are usually diagnosed on triple assessment 1) clinical evaluation, 2)   ultrasound scan, and 3) a large-core-needle biopsy under local anesthesia. We are aware that centchroman have  been used  with promising results in  for mastalgia and fibroadenoma. The centchroman is contraindicated in:

1.          Patient above 30 years of age

2.          Patients with fibroadenoma equal to or larger than 5 cm (giant fibroadenoma)

3.          Past history of breast carcinoma or family history of breast carcinoma

4.          Patients with polycystic ovarian diseases, cervical hyperplasia, and liver disease (these conditions may get worsened with Centchroman)

5.          Lactation period for first 6 months

6.          .Simple fibroadenoma is usually managed by natural observation, as they are benign and asymptomatic without any risk of future cancer.

. Complex fibroadenoma is associated with moderate risk of cancer and those associated with atypia (relative risk of >2) or family history of breast cancer should be excised Some patients prefer to have the lump excised because of pain, discomfort, psychological reasons, or fear of cancer. Large-core (Trucut) biopsy was performed to assess the histological features and to perform estrogen receptor and progesterone receptor (ER and PR) estimation. Patients  who were prescribe centchroman (an antiestrogen)  were evaluated after 1 week to check the tolerance to the drug and later followed at weeks 4, 8, 12, and 24 weeks  to assess the response to therapy. The ultrasound examination of the breast served as an objective measurement of volume assessment at 12 and 24th weeks .

Hormonal manipulation has been attempted to suppress the growth of fibroadenoma with antiestrogenic drug A)  tamoxifen as fibroadenoma is considered to arise from hyperresponsiveness of lobular tissue to estrogen.

Presence of estrogen receptors on tissue obtained from fibroadenoma has been described .  Hence, some also  use  B) other antiestrogen like  Centchroman, in order to suppress the proliferation of ductolobular tissue of fibroadenoma. Centchroman (ormeloxifene) is a nonsteroidal antiestrogen drug developed by the Central Drug Research Institute, Lucknow, India. It is a selective estrogen receptor modulator with weak agonist (on endometrium) and strong antagonist (on breast ductolobular epithelium) action

AS such, not only tamoxifen but  Centchroman, an antiestrogen drug, at a dosage of 30 mg daily for 3 months allowed complete regression of 31 % fibroadenoma, whereas only 7 % of lesions regressed completely with simple observation.