INFLUENCE OF THE HORMONAL REPLACEMENT THERAPY ON MAMMOGRAPHIC CHANGES

Abstract

Cilj istraživanja. Do danas nije točno određeno koliko često treba raditi mamografije ženama koje uzimaju hormonsko nadomjesno liječenje (HNL), pa smo odlučili provesti retrogradnu analizu mamografskih nalaza žena koje su na HNL. Želja nam je izdvojiti rizičnu skupinu žena, koje imaju povišeni rizik za razvoj raka dojke i koje bi trebalo češće kontrolirati. Materijal i metode. Istraživanje je obuhvatilo 79 žena koje uzimaju HNL. U svih njih je prije započinjanja HNL učinjena mamografija. Ispitanice su podijeljene u dvije skupine: u 39 žena kontrolni pregled uz mamografiju je ponovljen nakon jedne godine, a u 40 žena je kontrolna mamografija učinjena nakon dvije godine. Mamografski nalazi su klasificirani prema Wolfeu. U ispitanica je promatrano nekoliko parametara za koje se pretpostavilo da bi mogli utjecati na povećanje rizika za pojavu raka dojke. To su: osobna anamneza, obiteljska anamneza, broj poroda, dojenje, prethodna hormonska terapija te tip HNL. Rezultati. Mlađe žene u prosjeku uzimaju gestagensku hormonsku terapiju, a starije su uglavnom na kombiniranoj hormonskoj terapiji. Nije uočeno da vrsta HNL utječe na mamografski nalaz. U obje skupine ispitanica je u jednolikim udjelima došlo do pogoršanja ili poboljšanja mamografskog nalaza. Pogoršanje nalaza nađeno je u 5% žena koje su uzimale HNL jednu godinu te u 10% žena koje su primale HNL dvije godine. Zaključak. Kratkotrajno uzimanje HNL ne utječe na mamografski nalaz, te se mamografija može raditi jednom u dvije godine u žena koje uzimaju HNL.Objective. To date is not clear how often mammography should be performed in women on hormonal replacement therapy (HRT). We decided to make a retrograde analysis of mammograms in women on HRT in order to identify women at risk of breast cancer, who require more frequent follow-up examinations. Material and methods. The study included 79 women on HRT. All of them have performed mammography before introducing HRT. The patients were randomly assigned in two groups: in 39 patients clinical and mammographic follow-up was repeated after 1 year and in 40 patients after 2 years. The mammograms were classified according to Wolfe’s classification. Several parameters which were expected to potentially influence the risk of breast cancer were observed. These parameters include: personal history, family history, number of deliveries, lactation, earlier hormonal therapy and type of HRT. Results. The younger women on average are more often on progestin therapy while older women use a combined hormonal therapy. The type of HRT has not been observed to have any influence on mammograms. In both groups mammogram changes were observed in similar proportions of patients, e.g. no significant difference was observed. The follow-up mammogram was worse in 5% of the women on HRT during 1 year and 10% in the women on HRT during 2 years. Conclusion. The short-term use of HRT does not appear to have any influence on mammogram and it could be repeated every two years in women on HRT