CYCLOSPORINE-A AND MULTIPLE FIBROADENOMAS OF THE BREAST

Multiple bilateral fibroadenomas are uncommon. This finding in four wo men who had received renal transplants prompted further inquiry. A pro spective study was performed on 39 women under the age of 55 years who had received a renal transplant at least 1 year earlier. Clinical exa mination and breast ultrasonography were performed. Factors considered included immuno-suppressive therapy, concurrent medication and renal function. Blood was taken for estimation of oestradiol, prolactin, fol licle-stimulating hormone (FSH) and sex hormone binding globulin level s. Fibroadenomas were found in 13 of 29 women who had received cyclosp orin A: multiple in ten and bilateral in five. No abnormal breast find ings were seen in 10 patients immunosuppressed with steroids and azath ioprine alone (chi(2) = 7.30, 1 d.f., P < 0.01). Serum oestradiol conc entration was raised in women with fibroadenomas compared with that in those with normal breasts (P<0.05) and the level of FSH was lower (P< 0.01). Cyclosporin A may act on breast fibroblasts by humoral mechanis ms and direct action.