Hormonal replacement therapy: mammographic manifestations

Article Abstract:

Hormonal replacement therapy is often given to women who have gone through menopause. The therapy can help prevent bone loss and other problems seen in postmenopausal women and it may help prevent heart disease in these women. The therapy consists of estrogen or a combination of estrogen and progesterone. Both hormones can affect breast tissue and some reports have indicated that estrogen replacement therapy may cause changes in the breast that can be detected on mammograms, X-rays of the breasts. This study examined changes in breasts as seen on mammograms of women undergoing hormone replacement therapy. Out of 1,500 patients being treated with replacement therapy, 30 were identified as having had mammograms before, during, and after hormonal replacement therapy. The mammograms were reviewed for changes that occurred after therapy was initiated. Six patients from another population were identified as having changes in their breasts after therapy was begun. These women were monitored during treatment and after it was discontinued. In the six patients, mammograms showed increased fibroglandular tissue after therapy was begun. These increases returned to baseline levels after the therapy was discontinued. Of the 30 patients in the other part of the study, 16 had received both estrogen and progesterone therapy and 14 had received estrogen alone. In the 14 receiving estrogen alone, no mammographic changes were seen after therapy was begun. In the 16 receiving combination therapy, mammograms were unchanged after therapy was begun in 11 patients, minimal changes were seen in two patients, and moderate changes were seen in two patients. In one patient, no pre-therapy mammogram was available, but a mammogram taken after therapy was discontinued showed decreased fibroglandular tissue. Overall, mammograms showed changes in 5 of 30 (17 percent) patients after hormonal replacement therapy was begun. These results indicate that hormonal replacement therapy can cause changes in the breasts that are detectable on mammograms. This should be taken into consideration when mammographic results are abnormal. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Abnormalities, Hormone therapy, Estrogen, Estrogens, Progesterone, Breast

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Breast cancer: mammographic and sonographic findings after augmentation mammoplasty

Article Abstract:

Augmentation mammoplasty or cosmetic plastic surgery to increase the size of the breasts is increasingly being performed in the US. There is some concern that the breast implants used to increase breast size may prevent early detection of breast cancer by mammography (X-raying of the breasts) and sonography (ultrasound imaging). This study examined the effectiveness of mammography and sonography in detecting breast cancer in women who had undergone augmentation mammoplasty. The mammographic and sonographic results from 11 patients with diagnosed breast cancer who also had breast implants were reviewed. A breast mass or thickening was the initial finding in six patients. Mammography results were positive in four of the six cases and sonographic results were positive in one of the two cases where mammography results were negative. In five patients, no mass could be felt in the breasts and the cancer was found initially by mammography. The cancer appeared as microcalcifications (fine deposits of calcium) in three cases, as increased density in one case, and as asymmetric density in one case. The cancer had spread to the lymph nodes in only four cases. These results indicate that breast implants do not decrease the early detection of breast cancer by mammography. The views from which mammography is performed may need to be altered because of the implants, however. Sonography may be useful in cases where a mass can be felt but mammography findings are normal. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ultrasound imaging, Diagnosis, Breast cancer, Mammaplasty, Breast reconstruction

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Communication problems after mammographic screening

Article Abstract:

Accurate, understandable, and reliable communication between the radiologist and the referring physician is the basis of sound radiology consultation. This study assessed physician response to the radiologist's requests for immediate additional evaluation or biopsy made on the basis of abnormal findings on screening mammograms. The researchers found that a written report and follow-up telephone call to the referring physician's office were not sufficient to ensure prompt and reliable communication of potentially significant mammographic abnormalities in a large percentage of patients. It was concluded that for breast cancer screening to be effective, persistent follow-up visits to physicians' offices by patients with abnormalities on mammograms may be required to ensure that the report is received by the appropriate physician and is understood and acted upon in a timely manner.

Evaluation, Telecommunications systems, Communication in medicine, Medical communication, Radiologists

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