Increased mammographic breast density in acromegaly: quantitative and qualitative assessment.

CONTEXT

Mammographic density is a strong independent risk factor for breast cancer, whose prevalence in acromegaly is still controversial.

OBJECTIVE

To compare breast density in premenopausal acromegalic patients and controls and to determine whether density correlated with disease duration, GH, and IGF1 levels.

DESIGN, SETTING AND PARTICIPANTS: A prospective study involving 30 patients and 60 controls matched for age and body mass index.

INTERVENTIONS

A quantitative computer-aided mammographic density estimation (MDEST) and a qualitative blind evaluation by two experienced radiologists using the breast imaging reporting and data system (BI-RADS) was performed. Totally, 60 (acromegaly) and 120 (controls) craniocaudal and mediolateral oblique mammograms were evaluated in both patients and controls.

MAIN OUTCOME MEASURES

Breast density.

RESULTS

Patients showed a significantly (P<0.01) increased mammographic breast density with both methods (MDEST: 0.33 ± 0.21% and BI-RADS category: 2.81 ± 0.78) in comparison with controls (MDEST: 0.26 ± 0.19% and BI-RADS category: 2.35 ± 0.61). The agreement between the two methods and inter-observer agreement between the two radiologists were excellent (k=0.63 and k=0.85). In patients grouped according to disease activity (17 controlled and 13 uncontrolled) and medical therapy (15 treated and 15 untreated), no differences were found. All these groups had significantly increased mammographic breast density compared with controls (P<0.01). A positive correlation was found between mammographic breast density, IGF1 values and disease duration (r=0.29 and r=0.39), whereas it was not found with GH (r=-0.02).

CONCLUSIONS

Mammographic breast density in premenopausal acromegalic patients is significantly higher than controls and positively correlated with IGF1 and disease duration.