The Effect of HRT on Mammograms: Does Stopping Long-Term HRT for Four Weeks Significantly Improve the Quality of Screening Mammograms?

Abstract

Introduction. The risk of breast cancer is increased among menopausal women using HRT. Routine screening mammograms may be harder to interpret in HRT users; breast tissue may be denser and breast tenderness may reduce tolerance of adequate breast compression during mammography. Studies have reported lower specificity and sensitivity of screening mammograms in HRT users. Women are sometimes advised empirically to stop their HRT before screening mammography. We wanted to determine whether a short break from HRT would make a worthwhile difference to the quality of mammograms. In designing the study, established HRT users were surveyed. Although most said they were willing to stop HRT before mammography, 70% said they would not stop for more than four weeks. Methods. 48 women aged 48 to 65 were recruited from a menopause clinic. All had been using standard dose combined HRT for at least six months. Following bilateral oblique view mammograms the women stopped their HRT for four weeks and attended for repeat mammography. The paired mammograms were read by two consultant radiologists who were blinded to their timing. Study participants recorded any breast tenderness throughout the study and discomfort associated with each mammogram. Results. There was no significant difference between the densities of baseline and follow-up mammograms. There was no significant difference in reported breast tenderness and discomfort of mammograms before or after stopping HRT. There was no correlation between an individual's breast symptoms and the quality of her mammograms. Conclusions. This short break from HRT did not appear to make any important contribution to the quality of mammography. A longer break from HRT might have a greater effect but women in our clinic population said they would not tolerate a longer break. There is no value in advising women to stop their HRT a short time before screening mammography.Effects of red clover isoflavones (Promensil) versus placebo on uterine endometrium, vaginal maturation index and the uterine artery in healthy postmenopausal women R