[A mammographic evaluation of the morphostructural variations of the breast during hormone-replacement therapy in the postmenopause].

INTRODUCTION

Exogenous hormones may cause breast tissue changes, generally increasing its density. We used mammography to detect the to early effects of hormone replacement therapy in postmenopausal women.

MATERIAL AND METHODS

We examined 300 postmenopausal women (group A: 70 women in surgical menopause treated with estrogen replacement therapy; group B: 230 women in spontaneous menopause receiving estrogen and progestin replacement therapy). The mammographic patterns, according to Wolfe's classification, were compared with those of group C (case control group of 300 women) and group X after 1 year of therapy. The modification were classified as total and partial changes in mammographic density. The results were analyzed with Pearson's chi 2 test.

RESULTS

The evidence of a change in parenchymal pattern was found in 103/300 women (34.3%). Twenty-one women in group A and 82 in group B showed increased mammographic density (the DY breast by Wolfe). Partial changes were observed in 64 cases (21.3%). Comparing groups A and B to groups C and X (before therapy), the changes were statistically significant (p < .001), while comparing groups A and B the difference was not significant (p = 1.000).

CONCLUSIONS

The likely widespread use of hormone replacement therapy in the future will require an increase in the number of mammograms and a possible re-evaluation of sensitivity. To improve follow-up timing and to avoid a decrease in sensitivity, radiologists will have to consider both general and specific factors and to pay attention to the patterns of global increase in breast tissue density, the DY pattern of Wolfe's classification.