Association between fibrocystic breast disease and polycystic ovarian syndrome phenotypes: A cross-sectional study

Published date: Dec 03 2025

Journal Title: International Journal of Reproductive BioMedicine

Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 23, Issue No. 10

Pages: 815 – 826

DOI: 10.18502/ijrm.v23i10.20315

Ramesh Baradaran BagheriDepartment of Obstetrics and Gynecology, Alzahra Hospital, Faculty of Medicine, Alborz University of Medical Sciences, Karaj

Leila HajimaghsoudiDepartment of Surgery, Faculty of Medicine, Alborz University of Medical Sciences, Karaj

Seyedeh Sanaz MirrahimiMirrahimisanaz@gmail.comDepartment of Operation Room,Faculty of Paramedicine,Alborz University of Medical Sciences, Karaj

Abolfazl Mahmoudnezhad Atash beygDepartment of Pediatrics, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age and is associated with various hormonal and metabolic complications.

Objective: This study aimed to investigate the association between PCOS and fibrocystic breast disease (FBD) and to analyze the prevalence of FBD across different PCOS phenotypes.

Materials and Methods: In this cross-sectional study, data of 120 women diagnosed with either FBD or PCOS who referred to Kamali hospital, affiliated with Alborz University of Medical Sciences, Karaj, Iran from March 2024-March 2025 were extracted from their medical records. Participants were divided into 2 groups: PCOS (n = 65) and control (n = 55). The prevalence of FBD was compared between the PCOS and control groups. Furthermore, the distribution of FBD across different PCOS phenotypes (A-D) based on the Rotterdam criteria was analyzed. Hormonal profiles (luteinizing hormone, follicle-stimulating hormone, testosterone, estrogen, progesterone, anti-Müllerian hormone) and metabolic parameters were also compared between the groups.

Results: The prevalence of FBD was significantly higher in the PCOS group compared to the control group (58.3% vs. 30%; p = 0.003). The highest prevalence of FBD was observed in phenotype A (81.8%). Logistic regression analysis indicated that having PCOS increased the risk of developing FBD by more than 3 times (odds ratio = 3.12; 95% CI: 1.51–6.45). Levels of luteinizing hormone, follicle-stimulating hormone, and testosterone were significantly elevated in the PCOS group.

Conclusion: The findings of this study indicate that PCOS, particularly in phenotypes associated with hyperandrogenism and anovulation, is significantly associated with an increased prevalence of FBD. These results underscore the importance of breast health screening and monitoring in women with PCOS.

Keywords: Polycystic ovary syndrome, Fibrocystic breast disease, Hyperandrogenism, Phenotype

[1] Kunicki M, Smolarczyk R. Polycystic ovary syndrome and fibrocystic breast disease: An updated review. Horm Metab Res 2021; 53: 219–224.

[2] Karkera S, Agard E, Sankova L. The clinical manifestations of polycystic ovary syndrome (PCOS) and the treatment options. Eur J Biol Med Sci Res 2023; 11: 57–91.

[3] Baradaran Bagheri R, Chavoshinezhad N, Barghi B, Soleymaniinallou M, Shokoohi M, Najafnezhad P, et al. Effects of Cornus mas extract (Anthocyanin) and treadmill exercise on hormonal and histological effects in the rat model of polycystic ovary syndrome. Int J Women’s Health Reprod Sci 2025; 13: 37–43.

[4] Baradaran Bagheri R, Khaki AA. [Effects of carvacrol on hormonal and biochemical blood factors related to diabetes in diabetic adult rats induced by streptozocin]. Med J Tabriz Uni Med Sci 2024; 46: 136–144. (in Persian)

[5] Copp T, Muscat DM, Hersch J, McCaffery KJ, Doust J, Dokras A, et al. The challenges with managing polycystic ovary syndrome: A qualitative study of women’s and clinicians’ experiences. Patient Educ Couns 2022; 105: 719–725.

[6] Dewailly D. Diagnostic criteria for PCOS: Is there a need for a rethink? Best Pract Res Clin Obstet Gynaecol 2016; 37: 5–11.

[7] Jain S, Jain M, Shukla RC. Correlation of clinical, hormonal, biochemical and ultrasound parameters between adult and adolescent polycystic ovarian syndrome: Adult and adolescent PCOS. J Obstet Gynecol India 2022; 72 (Suppl.): 274–280.

[8] Mallick S, Benson R, Julka PK. Breast cancer prevention with anti-estrogens: Review of the current evidence and future directions. Breast Cancer 2016; 23: 170–177.

[9] Levin ER, Hammes SR. Estrogens and progestins. In: Brunton LL, Hilal-Dandan R, Knollmann BC. Goodman & Gilman’s: The pharmacological basis of therapeutics. USA: McGraw-Hill; 2011: 1163–1194.

[10] Bland KI, Copeland EM, Klimberg VS, Gradishar WJ. Bland and Copelands, The breast: Comprehensive management of benign and malignant diseases. 6th Ed. Switzerland: Elsevier Health Sciences; 2023.

[11] Davey MG, Hynes SO, Kerin MJ, Miller N, Lowery AJ. Ki-67 as a prognostic biomarker in invasive breast cancer. Cancers (Basel) 2021; 13: 4455.

[12] Baradaran Bagheri R, Salami SS, Mohammadzadeh Boukani L, Khaki AA. The regulatory effect of Eugenol on FSHR, LHCGR, and ER expression during follicular development in female rats with ovarian torsion. Int J Women’s Health Reprod Sci 2023; 11: 138–144.

[13] Harada M. Pathophysiology of polycystic ovary syndrome revisited: Current understanding and perspectives regarding future research. Reprod Med Biol 2022; 21: e12487.

[14] Wang R, Mol BWJ. The Rotterdam criteria for polycystic ovary syndrome: Evidence-based criteria? Hum Reprod 2017; 32: 261–264.

[15] Pratama G, Wiweko B, Asmarinah, Widyahening IS, Andraini T, Bayuaji H, et al. Mechanism of elevated LH/FSH ratio in lean PCOS revisited: A path analysis. Sci Rep 2024; 14: 8229.

[16] Mohammed ZI, Qasim MT. Correlation of AMH and LH levels in PCOS patients with pregnancy rate. Ann Roman Soc Cell Biol 2021; 25: 945–951.

[17] Mohammadi PM, Bagheri RB, Far FS, Ansari M, Mirzaei M, Zarepour F, et al. Evaluating the relationship between the attitude toward menopause and sexual function in postmenopausal women. Revista Latinoamericana Hipertens 2024; 19: 5.

[18] Eftekhar M, Bagheri RB, Neghab N, Hosseinisadat R. Evaluation of pretreatment with cetrotide in an antagonist protocol for patients with PCOS undergoing IVF/ICSI cycles: A randomized clinical trial. JBRA Assist Reprod 2018; 22: 238.

[19] Dilbaz B, Özkaya E, Cinar M, Cakir E, Dilbaz S. Cardiovascular disease risk characteristics of the main polycystic ovary syndrome phenotypes. Endocrine 2011; 39: 272–277.

[20] Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod Update 2014; 20: 748–758.

[21] Dang B, Clewis M, Miles B, Nguyen Q. The effect of polycystic ovarian syndrome on fibrocystic breast changes in postmenopausal women. Proc 2024; 37: 432–436.

[22] Harris H, Titus L, Cramer D, Terry K. Long and irregular menstrual cycles, polycystic ovary syndrome, and ovarian cancer risk in a population-based case-control study. Int J Cancer 2017; 140: 285–291.

[23] Kohnepoushi P, Dehghanbanadaki H, Mohammadzedeh P, Nikouei M, Moradi Y. The effect of the polycystic ovary syndrome and hypothyroidism on the risk of fibrocystic breast changes: A meta-analysis. Cancer Cell Int 2022; 22: 125.

[24] Harris HR, Cushing-Haugen KL, Webb PM, Nagle CM, Jordan SJ, Australian Ovarian Cancer Study Group, et al. Association between genetically predicted polycystic ovary syndrome and ovarian cancer: A mendelian randomization study. Int J Epidemiol 2019; 48: 822–830.

[25] De Leo V, Musacchio M, Cappelli V, Massaro M, Morgante G, Petraglia F. Genetic, hormonal and metabolic aspects of PCOS: An update. Reprod Biol Endocrinol 2016; 14: 38.