Changes in breast density during hormone treatment with transdermal estrogens alone or in combination with progesterone

Abstract

A retrospective observational study to assess whether hormonal treatment (HT) with transdermal estrogens alone or in combination with micronized progesterone increases breast density and to compare these changes to those of a control group of 4120 patients were not given HT. We included 150 patients whose baseline breast density was assessed with photon-counting spectral mammography and 1 year after hormone treatment. The reduction in breast density was compared using an analysis of covariance. The difference in breast density between mammographies in the HT group was −0.40 ± 5.5 and −0.85 ± 4.2 in the control group. The changes in density according to the type of HT, we found that women on treatment with estrogen alone presented a difference of 0.44 ± 5.8, and −1.35 ± 5 (p = 0.13) in women on combined treatment. After adjusting changes in density for age and average number of days between mammographies, we observed a difference of −0.36 95% confidence intervals (CI) [−1.04 to −0.31] in the women on HT and −0.71 95% CI [−1.65 to −0.21] in the control group. No increased breast density was observed in women on HT treatment, nor did we observe an increase according to HT type. The difference in breast density loss was smaller in the HT group versus the control group.

摘要

本研究是一项回顾性研究, 旨在评估单独用经皮雌激素或结合微粒化黄体酮的激素治疗(HT)是否会增加乳腺密度, 并与4120例未给予HT的对照组进行比较。我们纳入了150名患者, 通过量子计数乳腺X线摄影技术评估她们的基础乳腺密度, 并在激素治疗后1年进行复测。使用协方差分析比较乳腺密度的降低。HT组乳腺密度差值为0.40±5.5, 对照组为0.85±4.2。根据HT类型的乳腺密度变化, 我们发现单独使用雌激素治疗的女性与联合治疗的女性呈现出0.44±5.8和1.35±5的差异(p=0.13)。在调整了年龄和乳腺X光片之间平均天数的乳腺密度变化后, 我们观察到HT组妇女和对照组妇女之间的差异为0.36 95%CI[1.04-0.31]和0.71 95%CI[1.65-0.21]。在接受HT治疗的女性中没有观察到乳腺密度增加, 不同HT类型乳腺密度也没有增加。HT组乳腺密度减少与对照组相比差异较小。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Breast density
• mammography
• hormone replacement therapy
• transdermal estrogens
• micronized progesterone

Acknowledgments

This study has been done under the auspices of the Cátedra de Investigación en Obstetricia y Ginecologia. Hospital Universitario Dexeus, Universidad Autónoma de Barcelona.

Disclosure statement

The authors report no conflicts of interest.

Data statement

There are no linked research data sets for this paper. Data will be made available on request.