Postmenopausal hormone therapy and change in mammographic density
Postmenopausal hormone therapy and change in mammographic density
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DOI：
10.1093/jnci/95.1.30
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发表时间：
2003-01-01
期刊：
影响因子：
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通讯作者：
Ursin, G
中科院分区：
文献类型：
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作者：
Greendale, GA;Reboussin, BA;Ursin, G
背景：乳腺x线摄影密度是乳腺癌的独立危险因素。绝经后激素的使用与乳房x线摄影密度增加有关，但密度增加的幅度尚不清楚。方法:参加绝经后雌激素/黄体酮干预试验的875名妇女中，571名（65%）获得了基线和12个月乳房x线照片，随机分配接受安慰剂、每日结合马雌激素0.625 mg/天（CEE）、每日CEE和醋酸甲孕酮（MPA） 10 mg/天，第1-12天（CEE+MPA-循环）、每日CEE和MPA 2.5 mg/天（CEE+MPA-连续）。或每日CEE和微孕酮（MP），剂量为200 mg/天，第1-12天（CEE+MP）。我们分析了数字化的乳房x光片，以确定左乳房由致密组织组成的百分比（即乳房x光片密度百分比）。使用线性回归分析来检查治疗对基线和12个月之间乳房x线摄影百分比密度变化的影响，调整可能的混杂因素之前和之后。所有统计检验均为双侧检验。结果：在12个月内，CEE+ mpa -循环组、CEE+ mpa -连续组和CEE- mp组女性乳腺x线造影百分比密度的调整绝对平均变化分别为4.76%（95%置信区间[CI] = 3.29%至6.23%）、4.58% （95% CI = 3.19%至5.97%）和3.08% （95% CI = 1.65%至4.51%）。这些绝对平均变化与安慰剂组女性乳房x线摄影百分比密度调整后的绝对平均变化在统计学上有显著差异，后者为-0.07% （95% CI = -1.50%至1.38%）。结论：无论黄体酮是如何给药的，更高的x线摄影密度与使用雌激素/黄体酮联合治疗有关，但与仅使用雌激素无关。
Background: Mammographic density is an independent risk factor for breast cancer. Postmenopausal hormone use is associated with an increase in mammographic density, but the magnitude of the density increase is unknown. Methods: Baseline and 12-month mammograms were obtained for 571 (65%) of the 875 women, aged 45-64 years, who were enrolled in the Postmenopausal Estrogen/Progestin Interventions Trial and randomly assigned to receive placebo, daily conjugated equine estrogens at 0.625 mg/day (CEE), daily CEE and medroxyprogesterone acetate (MPA) at 10 mg/day on days 1-12 (CEE+MPA-cyclic), daily CEE and MPA at 2.5 mg/day (CEE+MPA-continuous), or daily CEE and micronized progesterone (MP) at 200 mg/day on days 1-12 (CEE+MP). We analyzed digitized mammograms to determine the percentage of the left breast that was composed of dense tissue (i.e., mammographic percent density). Linear regression analysis was used to examine the effects of treatments on the change in mammographic percent density between baseline and 12 months, before and after adjustment for possible confounders. All statistical tests were two-sided. Results: The adjusted absolute mean changes in mammographic percent density over 12 months were 4.76% (95% confidence interval [CI] = 3.29 % to 6.23 %), 4.58 % (95 % CI = 3.19 % to 5.97 %), and 3.08 % (95 % CI = 1.65 % to 4.51 %) for women in the CEE+MPA-cyclic, CEE+MPA-continuous, and CEE-MP groups, respectively. Each of those absolute mean changes was statistically significantly different from the adjusted absolute mean change in mammographic percent density for women in the placebo group, which was -0.07% (95% CI = -1.50% to 1.38%). Conclusion: Greater mammographic density was associated with the use of estrogen/progestin combination therapy, regardless of how the progestin was given, but not with the use of estrogen only.