Changes in mammographic and ultrasound image of the breast of women undergoing estrogen replacement therapy.

OBJECTIVE Evaluation of changes in mammographic and ultrasound image of the breast in female patients undergoing estrogen hormonal replacement therapy (ERT). MATERIAL AND METHODS 126 women with surgical menopause in case of benign disease using ERT and a control group of 100 women in menopause with no hormonal replacement therapy were selected for the study. Changes in the mammographic image were monitored in relation to individual types of breast according to Tabár's typology and with regard to the type of ERT application. In 38 women, changes in ultrasound image were also monitored together with ERT. RESULTS In 17 women (13 %) undergoing ERT, an increase in mammographic image density was found. This data was statistically significant in comparison with the control group without ERT (chi2 = 21.566, p < 0.0001). In 103 (82 %) women there was no change in mammographic density and in 6 women (5 %) decreased density despite using of ERT was found. In the group of patients undergoing ERT in peroral form, we found a greater percentage of women with an increased mammographic density (17 %) in comparison with the group of women with intradermally applied ERT (9 %). Increased density of mammographic image was more frequent in women with a prevalence of adipose tissue in their breasts (type II according to Tabár). In 8 patients (21 %) of 38 women with ultrasound examination an enlargement or development of new benign formations in the breast was found; this data was statistically insignificant in comparison with the control group. CONCLUSION In women with surgical menopause undergoing ERT, a statistically significant increase in the density of mammographic image was found (chi2 = 21.566, p < 0.0001). Increase in density of mammographic image was most frequent in women with a predominance of adipose tissue in breasts (a type II according to Tabár) and in women undergoing ERT in the peroral form. These data were statistically insignificant in 21 % of women with supplementary ultrasound examination enlargement and development of new benign lesions in the breasts were found.