Abstract
Studies on postmenopausal women have reported increased risk of breast cancer relating to the type and duration of hormone therapy (HT) used. Women with premature ovarian failure (POF) represent a challenge, since they require prolonged HT. Little is known about the impact of prolonged HT use on these women's breasts. This study aimed to evaluate the effects of one type of HT on the breast density of women with POF, compared with postmenopausal women. Cross-sectional study at the Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (Unicamp). 31 women with POF and 31 postmenopausal women, all using HT consisting of conjugated equine estrogen combined with medroxyprogesterone acetate, and matched according to HT duration, were studied. Mammography was performed on all subjects and was analyzed by means of digitization or Wolfe's classification, stratified into two categories: non-dense (N1 and P1 patterns) and dense (P2 and Dy). No significant difference in breast density was found between the two groups through digitization or Wolfe's classification. From digitization, the mean breast density was 24.1% ± 14.6 and 18.1% ± 17.2 in the POF and postmenopausal groups, respectively (P = 0.15). Wolfe's classification identified dense breasts in 51.6% and 29.0%, respectively (P = 0.171). There was no difference in breast density between the women with POF and postmenopausal women, who had used HT for the same length of time. These results may help towards compliance with HT use among women with POF.
Highlights
Studies carried out on postmenopausal women have shown increased risk of breast cancer relating to the type of hormone therapy (HT) used and the duration of its use.[1,2,3,4,5,6,7] It is still a matter for debate whether HT causes a reduction in the sensitivity and specificity of mammographic screening as a result of the increase in breast density.[8,9,10] The absolute risk of developing breast cancer, for a postmenopausal woman using estrogen-progestin HT, is individually very low
These women were receiving care at the gynecological endocrinology outpatient clinic of the Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (Unicamp), and they had been using an estrogen-progestin HT regimen composed of 0.625 mg of conjugated equine estrogen (CEE) combined with medroxyprogesterone acetate (MPA), cyclically or continuously, for at least 12 months
Women who had some form of pathological condition and/or had undergone previous breast surgery, women who smoked more than 20 cigarettes/ day and those with body mass index (BMI) > 30 kg/m2 were excluded from the study
Summary
Studies carried out on postmenopausal women have shown increased risk of breast cancer relating to the type of hormone therapy (HT) used and the duration of its use.[1,2,3,4,5,6,7] It is still a matter for debate whether HT causes a reduction in the sensitivity and specificity of mammographic screening as a result of the increase in breast density.[8,9,10] The absolute risk of developing breast cancer, for a postmenopausal woman using estrogen-progestin HT, is individually very low (an increase of eight cases per 10,000 women annually). The cumulative effect has greater repercussions and is not considered insignificant in the case of prolonged use.[11].
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