Mammographic changes associated with postmenopausal hormone replacement therapy: a longitudinal study

Article Abstract:

Hormone replacement therapy with estrogen or a combination of estrogen and progesterone is often recommended to postmenopausal women. Such therapy is thought to be beneficial in preventing bone loss, heart disease, and other diseases that occur at an increased rate in women after menopause. It is also thought that hormone replacement therapy may increase the risk for endometrial cancer when estrogen is given alone, but that adding progesterone to the estrogen negates this effect. A few reports have indicated that estrogen replacement therapy may cause changes in the breast that can be detected by mammography, X-ray imaging of the breasts. This study examined mammographic changes in the breast tissue of 50 women who received hormone replacement therapy. The women had mammograms taken within one year before starting hormone therapy and at least once a year after therapy was begun. Estrogen alone was given to 12 women and a combination of estrogen and progesterone was given to 38 women. On the pretreatment mammograms, breast tissue appeared dense in 9 (18 percent) women, fatty in 6 (12 percent) women, and heterogenous in 35 (70 percent) women. Mammograms taken approximately 18 months after treatment began showed that breast tissue density increased in 12 (24 percent) of the women. These results indicate that hormone replacement therapy can cause an increase in breast tissue density. The increased density is not a problem itself, but it can reduce the efficacy of mammography, and thus prevent the early detection of breast cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Abnormalities, Drug therapy, Hormone therapy, Menopause, Breast

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Clinically occult ductal carcinoma in situ detected with mammography: analysis of 100 cases with radiologic-pathologic correlation

Article Abstract:

Cancers of the ducts of the breast, ductal carcinoma in situ (DCIS) or as it is frequently termed, intraductal carcinoma, is characterized pathologically as a proliferation of cancerous duct cells which do not extend beyond the wall of the duct. Prior to the general use of mammography this cancer was considered relatively rare with an incidence of between .5 to .8 percent of all breast cancers. Due to massive screenings of breasts by mammography, smaller, unknown (occult) tumors are being detected and the incidence of DCIS is now reported in the range of 15 to 20 percent of all breast carcinomas. This study follows the disease course of one hundred cases of occult ductal carcinoma which were detected by mammography. The study relates size at detection, histologic (microscopic appearance), location, and association with calcium deposition with other clinical data. Women age 49 years or younger with DCIS were more likely to have associated calcium deposition (microcalcification) and soft-tissue mass. Microcalcifications were found in approximately 90 percent of the cases reported in this series. Its occurrence is probably related to the location within the duct system. Most DCIS cannot be detected by palpation (digital examination) and, consequently, mammography plays an important role in the detection of this cancer. It is not known how many of DCIS detected by mammography advance to a more aggressive invasive form of cancer. It is hoped that the use of mammography and a better system for evaluating biopsy results will allow a clearer understanding of the best method of treatment.

Diagnosis, Breast cancer, Mammary glands

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Suture calcification mimicking recurrence in the irradiated breast: a potential pitfall in mammographic evaluation

Article Abstract:

The development of small calcium deposits (microcalcifications) in the breast of women who have had breast surgery and radiation therapy is often an indication of the recurrence of the original cancer. During the past three years the authors have observed several cases where calcium deposition along sutures has mimicked the microcalcifications of recurrence. The mammographic findings are shown and examining physicians are encouraged to use magnification techniques in order to distinguish the benign calcification of suture material from recurrence. Recognition of the distinctive pattern of this condition can save women from the needless and traumatic effects of biopsy.

Evaluation, Causes of, Calcification, Sutures

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