Hormonal regulation of the breast is extremely complex. Changes associated with the menstrual cycle, pregnancy, lactation, state gland in the postpartum period, followed by an involution in menopause, etc., radically different, because due to enable or disable different levels of a number of hormones that regulate the reproductive, energy and adaptation homeostasis of the organism. Experimentally and clinically confirmed that the development of ducts and stroma cancer depends on the combined effects of insulin and estrogen (as it is known, are produced in the ovaries three classic female hormone estradiol, estrone and estriol), growth hormone and hydrocortisone, and stimulation of growth of the alveoli, i.e., glandular tissue, is under the influence of estrogen, progesterone (hormone yellow body), insulin and prolactin. Glucocorticoids secreted by the adrenal glands, and thyroxine, produced by the thyroid gland, contribute to the manifestation of the action of sex hormones (Dillman Century Meters, 1974). Because the secretion of the majority of ovarian hormones, adrenal glands, thyroid gland and pancreas is regulated by the pituitary gland (we will remind that by the pituitary gonadotropins are follicle-stimulating-FSH, luteotrophic - LH, adrenocorticotropic - ACTH, TSH - TSH), in General the state and function of the mammary gland affected by at least 13 various hormones, not counting the fact that, in addition to classical estrogen in the ovaries and the adrenal gland produces so-called non-classical finasteroide, and circulates in the body some more androgenetic substances.
Thus, there is a multifactorial hormonal effect on mammary glands as one of the components of complex reproductive system. Evaluation of these influences in the development of breast cancer even more difficult as the levels of many hormones does not extend beyond the physiological norms and can be detected only the change in their correlation. It explains the complexity of setting the indications for hormonal therapy and inefficiency of treatment number of patients seemingly favorably responds to hormonal effects. This remarkable paradox get good results in the absence of shifts endocrinology indicators during therapy. In this regard, hormone therapy in breast cancer does not give an objective assessment and its results are contradictory. I believe that only 30-40% of cancer patients sensitive to modern synthetic hormonal drugs and can positively respond to their medical application (Bulbrook, 1970).
Apart from the effect on the hormonal status, including on the Central mechanisms of gormonoobrazovanii, no less important is the direct action of hormones on the tumor cells. Determination of the level of sex chromatin and detection benefit of estrogen, androgen - and progestin.lorazepam in tumor cells (which was mentioned in Chapter VIII) confirmed the importance of the study of hormones on a cellular level.
Leaving aside the theoretical ideas and experimental evidence for the various parties to the mechanism of action of hormonal preparations, move on to the practical principles worked out in the clinic for therapy of patients with breast cancer.