Effects of estrogen and estrogen-progestin on mammographic parenchymal density
Effects of estrogen and estrogen-progestin on mammographic parenchymal density
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DOI：
10.7326/0003-4819-130-4_part_1-199902160-00003
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发表时间：
1999-02-16
影响因子：
39.2
通讯作者：
Barrett-Connor, E
中科院分区：
文献类型：
--
作者：
Greendale, GA;Reboussin, BA;Barrett-Connor, E
背景：在纵向研究中，较大的乳房 X 光密度与乳腺癌风险增加相关。目的：评估安慰剂、雌激素和三种雌激素-孕激素方案之间对乳房 X 光密度变化的差异。设计：一项为期 3 年、多中心、双盲、随机、安慰剂对照试验的子集分析。地点：七个流动研究中心。参与者：研究中 875 名女性中的 307 名。绝经后雌激素/孕激素干预试验。参与者进行了基线乳房 X 光检查和至少一次后续乳房 X 光检查，坚持治疗，在基线前至少 5 年没有服用雌激素，并且没有乳房植入物。干预：治疗为安慰剂、结合马雌激素 (CEE)、CEE 加循环醋酸甲羟孕酮 (MPA)、CEE 加每日 MPA 和 CEE 加循环微粉化黄体酮 (MP)。测量：变化乳房 X 光检查的放射线密度（根据美国放射学院乳腺成像报告和数据系统等级）。结果：几乎所有乳房 X 光密度的增加都发生在第一年内。 12 个月时，密度等级增加的女性比例在安慰剂组中为 0%（95% CI，0.0% 至 4.6%），在 CEE 组中为 3.5%（CI，1.0% 至 12.0%），在 CEE 加循环 MPA 组中为 23.5%（CI，11.9% 至 35.1%），19.4%（CI，9.9%） CEE 加每日 MPA 组为 16.4%（CI，6.6% 至 26.2%），CEE 加循环 MP 组为 16.4%（CI，6.6% 至 26.2%）。 12 个月时，与单独使用 CEE 相比，CEE 加循环 MPA 时乳房 X 光密度增加的几率为 13.1（95% CI，2.4 至 73.3），CEE 加每日 MPA 时为 9.0（CI，1.6 至 50.1），CEE 加循环微粉化黄体酮时为 7.2（CI，1.3 至 40.0）。结论：有必要进一步研究由于使用雌激素和雌激素-孕激素而导致的乳房X线照相密度增加的程度和意义，因为乳房X线照相密度可能是乳腺癌风险的标志。
Background: In longitudinal studies, greater mammographic density is associated with an increased risk for breast cancer.Objective: To assess differences between placebo, estrogen, and three estrogen-progestin regimens on change in mammographic density.Design: Subset analysis of a 3-year, multicenter, double-blind, randomized, placebo-controlled trial.Setting: Seven ambulatory study centers.Participants: 307 of the 875 women in the Postmenopausal Estrogen/Progestin Interventions Trial. Participants had a baseline mammogram and at least one follow-up mammogram available, adhered to treatment, had not taken estrogen for at least 5 years before baseline, and did not have breast implants.Intervention: Treatments were placebo, conjugated equine estrogens (CEE), CEE plus cyclic medroxyprogesterone acetate (MPA), CEE plus daily MPA, and CEE plus cyclic micronized progesterone (MP).Measurements: Change in radiographic density (according to American College of Radiology Breast Imaging Reporting and Data System grades) on mammography.Results: Almost all increases in mammographic density occurred within the first year. At 12 months, the percentage of women with density grade increases was 0% (95% CI, 0.0% to 4.6%) in the placebo group, 3.5% (CI, 1.0% to 12.0%) in the CEE group, 23.5% (CI, 11.9% to 35.1%) in the CEE plus cyclic MPA group, 19.4% (CI, 9.9% to 28.9%) in the CEE plus daily MPA group, and 16.4% (CI, 6.6% to 26.2%) in the CEE plus cyclic MP group. At 12 months, the odds of an increase in mammographic density were 13.1 (95% CI, 2.4 to 73.3) with CEE plus cyclic MPA, 9.0 (CI, 1.6 to 50.1) with CEE plus daily MPA, and 7.2 (CI, 1.3 to 40.0) with CEE plus cyclic micronized progesterone compared with CEE alone.Conclusions: Further study of the magnitude and meaning of increased mammographic density due to use of estrogen and estrogen-progestins is warranted because mammographic density may be a marker for risk for breast cancer.