Postmenopausal hormone therapy and changes in mammographic density.

TitlePostmenopausal hormone therapy and changes in mammographic density.
Publication TypeJournal Article
Year of Publication2007
Authorsvan Duijnhoven, FJB, Peeters, PHM, Warren, RML, Bingham, SA, van Noord, PAH, Monninkhof, EM, Grobbee, DE, van Gils, CH
JournalJ Clin Oncol
Volume25
Issue11
Pagination1323-8
Date Published2007 Apr 10
ISSN1527-7755
KeywordsAged, Breast, Europe, Female, Hormone Replacement Therapy, Humans, Mammography, Middle Aged, Postmenopause, Risk Factors, Surveys and Questionnaires
Abstract

PURPOSE: Hormone therapy (HT) use has been associated with an increased breast cancer risk. We explored the underlying mechanism further by determining the effects of HT on mammographic density, a measure of dense tissue in the breast and a consistent breast cancer risk factor.PATIENTS AND METHODS: A total of 620 HT users and 620 never users from the Dutch Prospect-European Prospective Investigation into Cancer and Nutrition (EPIC) cohort and 175 HT users and 161 never users from the United Kingdom EPIC-Norfolk cohort were included. For HT users, one mammogram before and one mammogram during HT use was included. For never users, mammograms with similar time intervals were included. Mammographic density was assessed using a computer-assisted method. Changes in density were analyzed using linear regression.RESULTS: The median time between mammograms was 3.0 years and the median duration of HT use was 1 year. The absolute mean decline in percent density was larger in never users (7.3%) than in estrogen therapy users (6.4%; P = .22) and combined HT users (3.5%; P < .01). The effect of HT appeared to be high in a small number of women, whereas most women were unaffected.CONCLUSION: Our results suggest that HT use, and especially estrogen and progestin use, slows the changes from dense patterns to more fatty patterns that are normally seen in women with increasing age. Given that it is postulated that lifetime cumulative exposure to high density may be related to breast cancer risk, a delay in density decline in HT users potentially could explain their increased breast cancer risk.

DOI10.1200/JCO.2005.04.7332
Alternate JournalJ. Clin. Oncol.
Citation Key10.1200/JCO.2005.04.7332
PubMed ID17312333
Grant ListMC_U105630924 / / Medical Research Council / United Kingdom