Effects of estrogen and estrogen-progestin on mammographic parenchymal density

Gail A. Greendale, Beth A. Reboussin, Angela Sie, H. Rosy-Singh, Linda K. Olson, Olga Gatewood, Lawrence W. Bassett, Carol Wasilauskas, Trudyn Bush, Elizabeth Barrett-Connor

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)262-269
Number of pages8
JournalAnnals of Internal Medicine
Volume130
Issue number4 I
StatePublished - Feb 16 1999

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Conjugated (USP) Estrogens
Progestins
Estrogens
Medroxyprogesterone Acetate
Placebos
Progesterone
Breast Density
Breast Neoplasms
Breast Implants
Mammography
Radiology
Information Systems
Longitudinal Studies
Breast

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Greendale, G. A., Reboussin, B. A., Sie, A., Rosy-Singh, H., Olson, L. K., Gatewood, O., ... Barrett-Connor, E. (1999). Effects of estrogen and estrogen-progestin on mammographic parenchymal density. Annals of Internal Medicine, 130(4 I), 262-269.

Effects of estrogen and estrogen-progestin on mammographic parenchymal density. / Greendale, Gail A.; Reboussin, Beth A.; Sie, Angela; Rosy-Singh, H.; Olson, Linda K.; Gatewood, Olga; Bassett, Lawrence W.; Wasilauskas, Carol; Bush, Trudyn; Barrett-Connor, Elizabeth.

In: Annals of Internal Medicine, Vol. 130, No. 4 I, 16.02.1999, p. 262-269.

Research output: Contribution to journalArticle

Greendale, GA, Reboussin, BA, Sie, A, Rosy-Singh, H, Olson, LK, Gatewood, O, Bassett, LW, Wasilauskas, C, Bush, T & Barrett-Connor, E 1999, 'Effects of estrogen and estrogen-progestin on mammographic parenchymal density', Annals of Internal Medicine, vol. 130, no. 4 I, pp. 262-269.
Greendale GA, Reboussin BA, Sie A, Rosy-Singh H, Olson LK, Gatewood O et al. Effects of estrogen and estrogen-progestin on mammographic parenchymal density. Annals of Internal Medicine. 1999 Feb 16;130(4 I):262-269.
Greendale, Gail A. ; Reboussin, Beth A. ; Sie, Angela ; Rosy-Singh, H. ; Olson, Linda K. ; Gatewood, Olga ; Bassett, Lawrence W. ; Wasilauskas, Carol ; Bush, Trudyn ; Barrett-Connor, Elizabeth. / Effects of estrogen and estrogen-progestin on mammographic parenchymal density. In: Annals of Internal Medicine. 1999 ; Vol. 130, No. 4 I. pp. 262-269.
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abstract = "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.",
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T1 - Effects of estrogen and estrogen-progestin on mammographic parenchymal density

AU - Greendale, Gail A.

AU - Reboussin, Beth A.

AU - Sie, Angela

AU - Rosy-Singh, H.

AU - Olson, Linda K.

AU - Gatewood, Olga

AU - Bassett, Lawrence W.

AU - Wasilauskas, Carol

AU - Bush, Trudyn

AU - Barrett-Connor, Elizabeth

PY - 1999/2/16

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N2 - 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.

AB - 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.

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