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Mammographic changes in postmenopausal women undergoing hormonal replacement therapy
1Department of Radiological Sciences, University of California, Irvine Medical Center, Orange 92668-3298.
AJR. American Journal of Roentgenology
|December 1, 1993
Summary
Postmenopausal women on hormone replacement therapy may experience mammographic changes like increased density or larger cysts. Differentiating these hormonal effects from cancer requires careful evaluation of mammograms.
Area of Science:
- Radiology
- Oncology
- Endocrinology
Background:
- Hormone replacement therapy (HRT) is increasingly used by postmenopausal women.
- Mammographic screening is crucial for early breast cancer detection in this demographic.
Purpose of the Study:
- To describe the range of mammographic alterations associated with HRT.
- To highlight the diagnostic challenges in distinguishing HRT effects from neoplastic changes.
Main Methods:
- Pictorial essay format.
- Review of mammographic findings in women undergoing HRT.
- Correlation of imaging findings with HRT type (estrogen alone vs. combined estrogen-progesterone).
Main Results:
- Common HRT-related mammographic changes include increased symmetric/asymmetric breast density, fibroadenoma enlargement, and cyst development/enlargement.
- Focal densities or masses can mimic malignancy, posing diagnostic challenges.
- Estrogen-only therapy is linked to cyst and fibroadenoma enlargement.
- Combined estrogen-progesterone therapy is associated with diffuse density increases.
Conclusions:
- Mammographic changes due to HRT are common but can mimic malignancy.
- Understanding these changes is vital for accurate interpretation and avoiding unnecessary biopsies.
- The specific HRT regimen may influence the pattern of mammographic alterations.