Abstract
Objective
To investigate the effects of 17β-estradiol 1 mg plus drospirenone 2 mg (E2/DRSP) treatment on mammographic breast density in perimenopausal women.
Study design
In this prospective study, 80 healthy perimenopausal women aged 41–49 years were enrolled
and assigned to either E2/DRSP (n = 40) or a control group (n = 40). Mammograms were performed at baseline and after 12 months of treatment. Mammographic
breast density was quantified according to the Wolfe classification.
Results
We demonstrated an increase in mammographic breast density in 37% (95% CI (confidence
interval): 18.8–55.3%) of women treated with E2/DRSP after 12 months. The percentage
of women with increased density was 0% (95% CI: 0.0–0.0%) in the control group. The
difference in breast density between the E2/DRSP group and the control group was statistically
very significant (p < 0.001).
Conclusions
E2/DRSP therapy for 12 months in perimenopausal women significantly increased mammographic
breast density in comparison to a control group. Further long-term and large scale
prospective studies are needed to evaluate this issue.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Obstetrics and Gynecology and Reproductive BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The association of breast mitogens with mammographic densities.Br J Cancer. 2002; 87: 876-882
- Risk for breast cancer development determined by mammographic parenchymal pattern.Cancer. 1976; 37: 2486-2492
- Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study.J Natl Cancer Inst. 1995; 87: 670-675
- Mammographic features and breast cancer risk: effects with time, age, and menopause status.J Natl Cancer Inst. 1995; 87: 1622-1629
- Timing is everything.Gynecol Endocrinol. 2007; 23: 1-4
- Relief of vasomotor symptoms and vaginal atrophy with lower doses of conjugated equine estrogens and medroxyprogesterone acetate.Fertil Steril. 2001; 75: 1065-1079
- Reversal by medical treatment of endometrial hyperplasia caused by estrogen replacement therapy.Menopause. 2001; 8: 420-423
- Effects of estrogen and estrogen–progestin on mammographic parenchymal density. Postmenopausal Estrogen/Progestin Interventions (PEPI) Investigators.Ann Intern Med. 1999; 130: 262-269
- Estrogen-plus-progestin use and mammographic density in postmenopausal women: women's health initiative randomized trial.J Natl Cancer Inst. 2005; 97: 1366-1376
- Hormone replacement therapy and the sensitivity and specificity of breast cancer screening: a review.J Med Screen. 2001; 8: 29-34
- Breast density and breast cancer risk factors in a high-risk population.Breast. 2003; 12: 10-16
- Progestin may modify the effect of low-dose hormone therapy on mammographic breast density.Climacteric. 2009; 12: 240-247
- Effects of a new oral contraceptive containing an antimineralocorticoid progestogen, drospirenone, on the renin-aldosterone system, body weight, blood pressure, glucose tolerance, and lipid metabolism.J Clin Endocrinol Metab. 1995; 80: 1816-1821
- Drospirenone: pharmacology and pharmacokinetics of a unique progestogen.Contraception. 2000; 62: 29-38
- Pharmacology of different progestogens: the special case of drospirenone.Climacteric. 2005; 8: 4-12
- Breast density changes associated with postmenopausal hormone therapy: post hoc radiologist- and computer-based analyses.Menopause. 2010; 17: 772-778
- Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis.Cancer Epidemiol Biomarkers Prev. 2006; 15: 1159-1169
- Mammographic densities and the growth hormone-IGF-1 prolactin axis.Proc Am Assoc Cancer Res. 2001; 42: 558
- A longitudinal study of the effects of menopause on mammographic features.Cancer Epidemiol Biomarkers Prev. 2002; 11: 1048-1053
- Wolfe's parenchymal pattern and percentage of the breast with mammographic densities: redundant or complementary classifications?.Cancer Epidemiol Biomarkers Prev. 2003; 12: 728-732
- Mammographic features and subsequent risk of breast cancer: a comparison of qualitative and quantitative evaluations in the Guernsey prospective studies.Cancer Epidemiol Biomarkers Prev. 2005; 14: 1052-1059
- The meaning of mammographic density in users of postmenopausal hormone therapy.Maturitas. 2002; 41: 171-175
- Interval cancers in the Norwegian Breast Cancer Screening Program: frequency, characteristics and use of HRT.Int J Cancer. 2001; 94: 594-598
- Short-term cessation of hormone replacement therapy and improvement of mammographic specificity.J Natl Cancer Inst. 1997; 89: 1623-1625
- Classification and pharmacology of progestins.Maturitas. 2003; 46: 7-16
- Comparative analysis of the uterine and mammary gland effects of drospirenone and medroxyprogesterone acetate.Endocrinology. 2008; 149: 3952-3959
- Safety, efficacy and patient acceptability of drospirenone and estradiol in the treatment of menopausal vasomotor symptoms: a review.Clin Interv Aging. 2009; 4: 59-62
- Effects of hormone replacement therapy on the mammary gland of surgically postmenopausal cynomolgus macaques.Am J Obstet Gynecol. 1996; 174: 93-100
- Hormone replacement therapy with estrogen or estrogen plus medroxyprogesterone acetate is associated with increase epithelial proliferation in the normal postmenopausal breast.J Clin Endocrinol Metab. 1999; 84: 4559-4565
- A correlative morphologic study of the human breast and endothelium in the menstrual cycle.Am J Surg Pathol. 1986; 10: 362-393
Article info
Publication history
Published online: September 26, 2011
Accepted:
September 1,
2011
Received in revised form:
June 7,
2011
Received:
December 1,
2010
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
