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Clinical evidence on the role of oestrogens in the development of the breasts

Published online by Cambridge University Press:  05 December 2011

Z. Laron ,
R. Kauli  and
A. Pertzelan
Z. Laron
Affiliation:
Institute of Pediatric and Adolescent Endocrinology, Beilinson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49 100, Israel
R. Kauli
Affiliation:
Institute of Pediatric and Adolescent Endocrinology, Beilinson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49 100, Israel
A. Pertzelan
Affiliation:
Institute of Pediatric and Adolescent Endocrinology, Beilinson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49 100, Israel
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Synopsis

Girls start their puberty including breast development around age 8. Though the best correlation found is that with oestradiol, most girls still have at the onset of breast development oestrogen levels in the normal range for adult males. Therefore, it seems that oestrogen receptor sensitivity plays an important role in breast development. An important insight into the hormonal interplay in breast development was obtained when comparing the effect of exogenous oestrogens in forty-five girls with four different aetiologies of oestrogen deficiency: gonadal dysgenesis (GD). 17-alpha hydroxylase deficiency (17-OHase def), isolated gonadotrophin deficiency (IGnD) and multiple pituitary hormone deficiencies (MPHD). None of the girls had any breast development in the absence of oestrogens. Treatment with oestrogen was given in an identical manner to all. In GD, in whom the hypothalamic-pituitary functions were normal, treatment led to full development of breasts in a relatively short period. In IGnD and MPHD, breast development was incomplete even after years of oestrogen treatment. The conspicuous difference of the hormonal status between GD and IGnD and MPHD is that the latter two groups lack gonadotrophins, while in GD and 17-OHase def. these hormones are pathologically elevated. Thus the gonadotrophins seem to play an important role in mammary gland development. In the girl with 17-OHase def., it was also found that cortisol is necessary for normal breast development. A girl with hyperprolactinaemia due to a microadenoma had delayed puberty including slow breast development. Upon bromocriptine treatment the prolactin fell, the oestrogens rose and puberty including breast development occurred. Patients with Laron-type dwarfism (isolated IGF-I deficiency) have been found to have normal breast development.

Type
Research Article
Information
Proceedings of the Royal Society of Edinburgh, Section B: Biological Sciences , Volume 95: Oestrogen and the Human Breast , 1989 , pp. 13 - 22
Copyright
Copyright © Royal Society of Edinburgh 1989

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