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Postmenopausal hormone therapy and change in mammographic density
Gail A Greendale1, Beth A Reboussin, Stacey Slone
1Division of Geriatric Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. ggrenda@mednet.ucla.edu
Journal of the National Cancer Institute
|January 2, 2003
Summary
Postmenopausal hormone therapy containing estrogen and progestin increases mammographic density, a breast cancer risk factor. Estrogen-only therapy did not show this effect.
Area of Science:
- Endocrinology
- Oncology
- Radiology
Background:
- Mammographic density is a known independent risk factor for breast cancer.
- Postmenopausal hormone use is linked to increased mammographic density, but the extent of this increase is not well-defined.
Purpose of the Study:
- To quantify the effect of different postmenopausal hormone therapies on mammographic density.
- To determine if estrogen-only or combined estrogen/progestin therapy impacts mammographic density differently.
Main Methods:
- 12-month mammograms from 571 women (aged 45-64) in the Postmenopausal Estrogen/Progestin Interventions Trial were analyzed.
- Digitized mammograms assessed the percentage of dense breast tissue.
- Linear regression analyzed changes in mammographic percent density across treatment groups (placebo, CEE, CEE+MPA, CEE+MP).
Main Results:
- Combined estrogen/progestin therapies (CEE+MPA-cyclic, CEE+MPA-continuous, CEE+MP) significantly increased mammographic percent density compared to placebo.
- The mean absolute increases in mammographic density ranged from 3.08% to 4.76% for combination therapies.
- Estrogen-only therapy (CEE) did not result in a statistically significant change in mammographic density compared to placebo.
Conclusions:
- Estrogen/progestin combination therapy is associated with increased mammographic density.
- The method of progestin administration (cyclic or continuous) did not alter the effect on mammographic density.
- Estrogen-only therapy does not appear to increase mammographic density.