Litherland J C, Evans A J, Wilson A R
Breast Screening Training Centre, Nottingham City Hospital, UK.
Clin Radiol. 1997 Apr;52(4):276-9. doi: 10.1016/s0009-9260(97)80053-0.
Hormone replacement therapy (HRT) can lead to an increase in the density of breast parenchyma on mammography and to the development of mammographically visible cysts and fibroadenomas. These changes may obscure features indicative of benign processes or mimic those of a carcinoma on screening mammography. This study was designed to assess the effect of HRT usage on the recall rate of women attending for routine breast screening.
Details of HRT usage were taken from 5699 consecutive women aged 49-64 attending for breast screening. Mammograms were read without knowledge of HRT usage and recall for assessment details collected.
A significant fall in recall rate was seen between the prevalent and incident screens in women not taking HRT (P < 0.016). This fall was not present in women taking HRT. The recall rate for the incident screen of women on HRT was 37% higher than that for women who did not take HRT; however the positive predive value for cancer of recall was lower at 3.7% compared to 12.9%.
These results indicate that the recall rate for incident screening is likely to be higher in women on HRT. This increase in assessment will lead to increased cost and anxiety in the screened population.
激素替代疗法（HRT）可导致乳房X线摄影中乳腺实质密度增加，并出现乳房X线摄影可见的囊肿和纤维腺瘤。这些变化可能会掩盖提示良性病变的特征，或在筛查性乳房X线摄影中模仿癌的特征。本研究旨在评估使用HRT对参加常规乳房筛查的女性召回率的影响。
从5699名年龄在49 - 64岁连续参加乳房筛查的女性中获取HRT使用细节。在不知道HRT使用情况的前提下阅读乳房X线照片，并收集召回以进行评估的细节。
未使用HRT的女性在现患筛查和新发病例筛查之间召回率显著下降（P < 0.016）。使用HRT的女性中未出现这种下降。使用HRT的女性新发病例筛查的召回率比未使用HRT的女性高37%；然而，召回病例的癌症阳性预测值较低，分别为3.7%和12.9%。
这些结果表明，使用HRT的女性新发病例筛查的召回率可能更高。这种评估增加将导致筛查人群的成本和焦虑增加。
