Local intracystic application of methotrexate in the treatment of recurrent breast cysts

Background: In the aetiopathogenesis of fibrocystic changes of the breast, an essential role is played by disturbances of metabolism in the monoamines, oestrogens and growth factors.
Aim of the study: To assess the results of treatment of recurrent breast cysts by the inhibitors aromatase, bromo-criptine and local intracystic injections of methotrexate.
Material and methods: 45 preme-nopausal women aged 42–45 were enrolled in this study according to ultrasound and mammographic criteria and were divided into two groups. The control group comprised 20 women without changes in the breast gland. The study group comprised 25 women with recurrent breast cysts. Under ultrasound quite fine-needle biopsy of the cysts was performed and, the cysts having been emptied, methotrexate in the dose of 50 mg/24 h and oral aromatase inhibitor with bromocriptine were locally injected into the cysts. Biochemical analysis was performed by photometric and immunoenzymatic methods.
Results: The diameter of the cyst the longer the time elapsed to achieve resorption of the cysts.
Conclusions:
1. Local intracystic fine needle methotrexate injection may be a mode of choice in the treatment of recurrent breast cancer cysts. 2. Single injection in the dose of 50 mg/24 h of methotrexate into recurrent breast cysts emptied during fine needle biopsy aspiration did not lead to undesirable side effects. 3. Combined treatment of relative hyperoestrogenism and hyperprolacti-naemia with local intracystic methotrexate application has profitable therapeutic effects.