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Mammographic changes in postmenopausal women on hormonal replacement therapy

  • Breast Radiology
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Abstract

The purpose of this study was to investigate the extent of the effects of hormonal replacement therapy (HRT) on the mammographic breast pattern in postmenopausal women. In a hospital-based study mammographic examinations of 81 postmenopausal women were evaluated retrospectively, before and after 1–2 years of treatment with oestrogens or a combination of oestrogens and progestagens. Each individual mammographic film was examined separately, and the glandular tissue was classified according to a modified Wolfe classification. In a screening-centre-based study two consecutive mammograms, with a 2-year interval, of 645 women, of whom 70 were using some kind of hormone therapy, were evaluated retrospectively. In the hospital-based study 31% of patients treated with combination HRT showed an increase in fibroglandular tissue compared with only 8.7% in the group treated with oestrogens alone. The difference was statistically significant (p=0.046). In the screening-based study 14.3% of the women using hormonal therapy showed an increase, whereas in the non-users no increase was found (p=1.24×10−10). After beginning HRT many women (between 14 and 25% in our experience) can be expected to undergo a mammographically detectable increase in fibroglandular tissue. Radiologists should be aware of the aetiology of such changes, and can obtain information on HRT most conveniently by having the technologist routinely question each patient.

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References

  1. Hammond CB, Maxson WS (1982) Current status of estrogen therapy for the menopause. Fertil Steril 37: 5

    PubMed  CAS  Google Scholar 

  2. Ravnikar V (1990) Physiology and treatment of hot flushes. Obstet Gynecol 75 (Suppl): 3

    Google Scholar 

  3. Ettinger B (1988) Prevention of osteoporosis: treatment of estradiol deficiency. Obstet Gynecol 72: 12

    Google Scholar 

  4. Naesson T, Persson I, Adami HO, Bergström R, Bergkvist L (1990) Hormone replacement therapy and the risk for hip fracture. Ann Intern Med 113: 95

    Google Scholar 

  5. Stampfer MJ, Colditz GA (1991) Estrogen replacement therapy and coronary heart disease: a quantitative assesment of the epidemiologic evidence. Prev Med 20: 47

    Article  PubMed  CAS  Google Scholar 

  6. Falkeborn M, Persson I, Adami HO, Bergstrom R, Eaker E, Lithell H, Mohsen R, Naessen T (1992) The risk of acute myocardial infarction after oestrogen and oestrogen-progestogen replacement. Br J Obstet Gynaecol 99: 821

    PubMed  CAS  Google Scholar 

  7. Creasy GW, Kafrissen ME, Upmalis D (1992) Review of the endometrial effects of estrogens and progestins. Obstet Gynecol Surv 47: 654

    Article  PubMed  CAS  Google Scholar 

  8. Kaufman Z, Garstin WIH, Hayes R, Michell MJ, Baum M (1991) The mammographic parenchymal patterns of women on hormonal replacement therapy. Clin Radiol 43: 389

    Article  PubMed  CAS  Google Scholar 

  9. Buchanan JB, Weisberg BF, Sandoz JP, Gray LA, Bland KI (1981) Selected prognostic variables for mammographic parenchymal patterns. Cancer 47: 2135

    Article  PubMed  CAS  Google Scholar 

  10. Waard F de, Rombach JJ, Collette HJA, Slotboom B (1984) Breast cancer risk associated with reproductive factors and breast parenchymal patterns. J Natl Cancer Inst 72: 1277

    PubMed  Google Scholar 

  11. Verbeek ALM, Hendriks JHCL, Peeters PHM, Sturmans F (1984) Mammographic breast pattern and the risk of breast cancer. Lancet 1: 591

    Article  PubMed  CAS  Google Scholar 

  12. Leinster SJ, Walsh PV, Whitehouse GH, Al-Sumidaie AM (1988) Factors associated with mammographic parenchymal patterns. Clin Radiol 39: 252

    Article  PubMed  CAS  Google Scholar 

  13. Van der Mooren MJ, Demacker PNM, Thomas CMG, Borm GF, Rolland R (1993) A 2-year study on, the beneficial effects of 17β-oestradiol-dydrogesterone therapy on serum lipoproteins and Lp(a) in postmenopausal women: no additional unfavourable effects of dydrogesterone. Eur J Obstet Gynecol Reprod Biol 52: 117

    Article  PubMed  Google Scholar 

  14. Van der Mooren MJ, Gevers Leuven JA, Rolland R (1994) Effect of conjugated estrogen with and without medrogestone: a prospective study. Maturitas 19: 33

    Article  PubMed  Google Scholar 

  15. Wolfe JN (1976) Breast patterns as an index of risk for developing breast cancer. AJR 126: 1130

    PubMed  CAS  Google Scholar 

  16. Peyster RG, Kalisher L, Cole PH (1977) Mammographic parenchymal patterns and the prevalence of breast cancer. Radiology 125: 387

    PubMed  CAS  Google Scholar 

  17. Tabár L, Dean PB (1982) Mammographic parenchymal patterns, risk indicator for breast cancer? J Am Med Assoc 247: 185

    Article  Google Scholar 

  18. Berkowitz JE, Gatewood OMB, Goldblum LE, Gayler BW (1990) Hormonal replacement therapy: mammographic manifestations. Radiology 174: 199

    PubMed  CAS  Google Scholar 

  19. Stomper PC, Van Voorhis BJ, Ravnikar VA, Meyer JE (1990) Mammographic changes associated with postmenopausal hormone replacement therapy: a longitudinal study. Radiology 174: 487

    PubMed  CAS  Google Scholar 

  20. Cyrlak D, Wong CH (1993) Mammographic changes in postmenopausal women undergoing hormonal replacement therapy. AJR 161: 1177

    PubMed  CAS  Google Scholar 

  21. Kuttenn F, Fournier S, Sitruk-Ware R, Martin P, Mauvais-Jarvis P (1983) Progesterone deficiency in benign breast disease. In: Angeli A, Bradlow ML, Dogliotti L (ed) Endocrinology of cystic breast disease. Raven Press. New York, pp 231–252

    Google Scholar 

  22. Key TJA, Pike MC (1988) The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer. Eur J Cancer Clin Oncol 24: 29

    Article  PubMed  CAS  Google Scholar 

  23. Wingo PA, Layde PM, Lee NC, Rubin G, Ory HW (1987) The risk of breast cancer in postmenopausal women who have used estrogen replacement therapy. J Am Med Assoc 257: 209

    Article  CAS  Google Scholar 

  24. Gambrell RD Jr (1984) Proposal to decrease the risk and improve the prognosis of breast cancer. Am J Obstet Gynecol 150: 119

    PubMed  Google Scholar 

  25. Hunt K, Vessey M, McPherson K, Coleman M (1987) Longterm surveillance of mortality and cancer incidence in women receiving hormone replacement therapy. Br J Obstet Gynaecol 94: 620

    PubMed  CAS  Google Scholar 

  26. Bergkvist L, Adami HO, Persson I, Hoover R, Schairer C (1989) The risk of breast cancer after estrogen and estrogen-progestin replacement. N Engl J Med 321: 293

    Article  PubMed  CAS  Google Scholar 

  27. Dupont WD, Page DL (1991) Menopausal estrogen replacement therapy and breast cancer. Arch Intern Med 151: 67

    Article  PubMed  CAS  Google Scholar 

  28. Henderson IC (1993) Risk factors for breast cancer development. Cancer 71 (Suppl): 2127

    Article  PubMed  CAS  Google Scholar 

  29. Tabár L, Faberberg G Day NE, Holmberg L (1987) What is the optimum interval between mammographic screening examinations? An analysis based on the latest results of the Swedish two-county breast cancer screening trial. Br J Cancer 55: 547

    PubMed  Google Scholar 

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Author notes

  1. R. C. Marugg

    Present address: Department of Radiology, H. E. Oduber Hospital, P.O. Box 569, Oranjestad, Aruba

Authors and Affiliations

  1. Department of Diagnostic Radiology, University Hospital Nijmegen St. Radboud, Geert Grooteplein Zuid 18, P.O Box 9101, NL-6500 HB, Nijmegen, The Netherlands

    R. C. Marugg, J. H. C. L. Hendriks & S. H. J. Ruijs

  2. Department of Obstetrics and Gynaecology, University Hospital Nijmegen St. Radboud, Geert Grooteplein Zuid 16, P.O. Box 9101, NL-6500 HB, Nijmegen, The Netherlands

    M. J. van der Mooren & R. Rolland

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  1. R. C. Marugg
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  2. M. J. van der Mooren
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  3. J. H. C. L. Hendriks
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  4. R. Rolland
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Marugg, R.C., van der Mooren, M.J., Hendriks, J.H.C.L. et al. Mammographic changes in postmenopausal women on hormonal replacement therapy. Eur. Radiol. 7, 749–755 (1997). https://doi.org/10.1007/BF02742938

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  • DOI: https://doi.org/10.1007/BF02742938

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