POSTMENOPAUSAL HORMONE REPLACEMENT THERAPY; CHANGES OF THE MAMMOGRAPHIC FINDINGS

Objective: HRT is known to result mammographic alterations, especially elevating the density that decreases the sensitivity of the mammography. In this study we have aimed to display the effect of HRT on the mammographic findings in consideration with the therapy protocols. Material and Methods: 1025 cases who were in menopause for at least 1 year and administered HRT for at least 1 year were chosen as a study group that was compared to the control group which includes 111 cases who did not received HRT. Two consecutive mammographies were retrospectively evaluated. Densitometric measurements ( quantitative method), Wolfe classification findings were compared between before and after HRT. The new developing lesions, alterations in the present lesions were also evaluated by dividing the cases according to protocols; continues combined, cyclic combined, estrogenconjugated estrogen, tibolone, the control group. Results: The most prominent increase in the density was in the continues combined group(% 49, p= 0.001). Estrogen therapy group was observed. Tibolone had the minimal effect(% 28, p> 0.05). The increase in the density of the tibolone group was statistically insignificant in all evaluations. In the control group, the alteration was towards decrease in the density (% 44, p< 0.0000).. In the estrogen therapy group, the development of malignant lesions was statistically significant (% 5, p< 0.02). ( 2 case DCIS, 2 case IDC). In the tibolone group the regression in the lesions was significant. Conclusion: Continues combined therapy increases the density of breast signifi cantly, tibolone is the minimal eff ective drug. In the estrogen therapy group, the development of malign lesions after HRT was statistically signifi cant.