ELEVATED HIGH-DENSITY-LIPOPROTEIN CHOLESTEROL AND DIETARY-FAT INTAKE IS WOMEN WITH CYCLIC MASTOPATHY

OBJECTIVE: This study was designed to examine the contribution of plas ma lipids to the pathophysiology of cyclic mastopathy, before and afte r consideration of diet and sex hormones. STUDY DESIGN: Thirty-four wo men with severe cyclic mastopathy (case patients) and 29 women without cyclic mastopathy (control subjects) recorded their breast symptoms d aily during 1 menstrual cycle. During each menstrual phase (follicular , early luteal, late luteal, and menstrual) they prospectively complet ed 2 24-hour dietary diaries, provided blood for lipid and hormone ass ays, and underwent anthropometric measurements. RESULTS: Mean age was 34 years. Premenstrual breast swelling and tenderness were significant ly more severe in case patients (P < .0001). Cyclic change (late lutea l vs follicular) of high-density lipoprotein cholesterol differed betw een case patients and control subjects. with case patients having a re lative excess of high-density lipoprotein cholesterol in the premenstr ual phase (P = .01). Dietary fat intake was greater throughout the cyc le in case patients (37.5 vs 33.7% of calories, P = .02), and case pat ients reported increased appetite in the premenstrual phase (P = .01). In multivariate analyses the contributions of mean dietary fat intake and of cyclic change in high-density lipoprotein cholesterol were ind ependently significant, with odds ratios for upper versus lower quinti les being slightly >5. CONCLUSIONS: Women with cyclic mastopathy had a relative excess of high-density lipoprotein cholesterol during the sy mptomatic late luteal phase of the menstrual cycle and a higher fat in take throughout the cycle than did control subjects. These observation s support the hypothesis that lipids (notably high-density lipoprotein cholesterol) and a high-fat diet play a role in the pathophysiologic characteristics of cyclic mastopathy.