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在一项评估巴多昔芬/结合雌激素的随机对照试验中,乳腺密度的变化。

Breast density changes in a randomized controlled trial evaluating bazedoxifene/conjugated estrogens.

机构信息

Department of Radiology, University of Virginia Health System, Charlottesville, VA 22908, USA.

出版信息

Menopause. 2013 Feb;20(2):138-45. doi: 10.1097/gme.0b013e318271f5e7.

Abstract

OBJECTIVE

Breast density is associated with an increased risk of breast cancer. This study assessed changes in mammographic breast density after 24 months of treatment with bazedoxifene (BZA)/conjugated estrogens (CE) in postmenopausal women.

METHODS

This was an ancillary study in a subset of nonhysterectomized postmenopausal women enrolled in a randomized, double-blind, placebo-controlled, and active-controlled phase 3 study. Treatments evaluated were BZA 20 mg/CE 0.45 mg, BZA 20 mg/CE 0.625 mg, raloxifene 60 mg, and placebo. Women who were eligible for participation in the ancillary study must have completed 24 months of treatment and have mammograms at baseline and 24 months. The left craniocaudal views from each mammogram pair were digitized and analyzed by a radiologist who was blinded to treatment arm and mammogram date. The percent breast density was determined using validated software.

RESULTS

Mammogram pairs were obtained from 507 evaluable participants (mean age range, 55.2-56.3 y). The mean changes (95% CI) in mammographic breast density from baseline to 24 months were comparable among groups (-0.39% [-0.69 to -0.08], -0.05% [-0.38 to 0.27], -0.23% [-0.54 to 0.08], and -0.42% [-0.72 to -0.11] for BZA 20 mg/CE 0.45 mg, BZA 20 mg/CE 0.625 mg, raloxifene 60 mg, and placebo, respectively). These reductions from baseline were statistically significant for BZA 20 mg/CE 0.45 mg and placebo. The effect of both BZA/CE doses on breast density was generally consistent among subgroups based on age, body mass index, and years since menopause.

CONCLUSIONS

Treatment with BZA 20 mg/CE 0.45 mg or BZA 20 mg/CE 0.625 mg for 24 months did not affect mammographic breast density in this population of postmenopausal women.

摘要

目的

乳腺密度与乳腺癌风险增加相关。本研究评估了绝经后妇女使用巴多昔芬(BZA)/结合雌激素(CE)治疗 24 个月后乳腺密度的变化。

方法

这是一项在随机、双盲、安慰剂对照和阳性对照 3 期研究中纳入的非子宫切除的绝经后妇女亚组的辅助研究。评估的治疗方法为 BZA 20mg/CE 0.45mg、BZA 20mg/CE 0.625mg、雷洛昔芬 60mg 和安慰剂。有资格参加辅助研究的妇女必须完成 24 个月的治疗,并在基线和 24 个月时有乳房 X 光片。对每对乳房 X 光片的左侧颅尾视图进行数字化,并由一位对治疗臂和乳房 X 光片日期均不知情的放射科医生进行分析。使用经过验证的软件确定乳腺密度的百分比。

结果

从 507 名可评估参与者中获得了乳房 X 光片对(平均年龄范围为 55.2-56.3 岁)。从基线到 24 个月,各组的乳腺密度变化平均值(95%CI)相似(-0.39%[-0.69 至 -0.08]、-0.05%[-0.38 至 0.27]、-0.23%[-0.54 至 0.08]和-0.42%[-0.72 至 -0.11],分别为 BZA 20mg/CE 0.45mg、BZA 20mg/CE 0.625mg、雷洛昔芬 60mg 和安慰剂)。BZA 20mg/CE 0.45mg 和安慰剂的这些基线降低具有统计学意义。两种 BZA/CE 剂量对乳腺密度的影响在基于年龄、体重指数和绝经年限的亚组中基本一致。

结论

在本绝经后妇女人群中,使用 BZA 20mg/CE 0.45mg 或 BZA 20mg/CE 0.625mg 治疗 24 个月不会影响乳房 X 光片的乳腺密度。

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