Objective: To determine the features of the breast ultrasound image and its correlation with estrogen and progestogen level during different phases of menstrual cycle in normal women.
Methods: Breast ultrasound was performed during luteal phase and late follicular phase in 50 women aged 25-45, with normal menstrual cycle and no distinct breast disease. Breast section thickness, ductal width, breast structure and blood flow were measured. Initial time and persistent days of the cyclic breast pain were recorded. Serum estradiol (E2) and progesterone (P) levels were measured by enzyme immunoassay on the day of ultrasound performed.
Results: Breast glandular section was thicker (increasing by 7.3%) in luteal phase than that in late follicular phase and breast ductal was wider (increasing by 13%) in late follicular phase than that in luteal phase. However, both of them had no significant difference. Thirty women (60%) experienced cyclic premenstrual mastalgia, lasting 4 days. Twenty four women (48%) had breast structure changes, nineteen (63.3%) of 30 women with cyclic mastalgia, but only 5 (25%) of 20 women without breast pain had breast structure change (chi 2, P < 0.01). Average serum E2 level of women with or without cyclic breast pain in luteal phase were 365.0 pmol/L and 335.3 pmol/L respectively (P > 0.05), serum progesterone level were 73.3 nmol/L and 66.1 nmol/L respectively (P > 0.05). Serum E2 levels of women with or without cyclic breast pain in late follicular phase were 299.9 pmol/L and 385.8 pmol/L respectively (P = 0.05). Average serum E2 levels of women with or without breast structure change in luteal phase were 368.1 pmol/L and 322.7 pmol/L respectively (P < 0.05). Serum P levels were 78.8 nmol/L and 62.2 nmol/L respectively (P = 0.05); Estradiol levels in late follicular phase were 301.9 pmol/L and 364.2 pmol/L respectively (P > 0.05).
Conclusions: Image of breast ultrasound changed following menstrual cycle in normal menstrual women. Breast structure changes is related to breast pain. Breast pain and breast structure changes may be caused by higher E2 and P level in luteal phase and lower E2/P ratio in late follicular phase.