Breast density in women with premature ovarian failure using hormone therapy

Benetti‐Pinto, Cristina Laguna; Soares, Patrícia Magda; Magna, Luís Alberto; Petta, Carlos Alberto; Santos, César Cabello dos

doi:10.1080/09637480701690543

Cited by 14 publications

(7 citation statements)

References 24 publications

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“…The risk may be reduced in women with untreated POI, due to reduced estrogen exposure (Rebbeck et al , 2009; Wu et al , 2014). HRT does not affect breast density in women with spontaneous POI (Benetti-Pinto et al , 2008; Soares et al , 2010). Other studies confirm the absence of an increased risk for breast cancer in women with POI taking HRT (Ewertz et al , 2005; Bosze et al , 2006).…”

Section: Resultsmentioning

confidence: 95%

HRT for women with premature ovarian insufficiency: a comprehensive review

Webber

Anderson

Davies

et al. 2017

Human Reproduction Open

106

117

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BACKGROUND Premature ovarian insufficiency (POI), often and misleadingly referred to as ‘premature menopause’, is defined as a loss of ovarian activity before the age of 40 years and is characterized by irregular or absent periods and reduced fertility. Symptoms include those associated with the natural menopause (night sweats and vaginal dryness), and with the long-term adverse effects of estrogen deficiency (osteoporosis and cardiovascular disease): the latter is believed to explain the shorter life expectancy associated with POI. OBJECTIVE AND RATIONALE The objective of the current review was to collect all relevant studies supporting recommendations on the indications, treatment options, and risks of hormone replacement therapy (HRT) (estrogen, progestogens and androgens) for women with POI. SEARCH METHODS The current review was written based on the best available evidence on the topic collected for the recently published ESHRE guideline on the management of women with POI. PUBMED/MEDLINE and the Cochrane library were searched in a stepwise approach. Relevant references were summarized in evidence tables, with assessment of the quality. OUTCOMES HRT is strongly recommended for women with POI, mainly for vasomotor and genito-urinary symptom relief. In addition, HRT has been shown to have a role in bone protection and probably also in primary prevention of cardiovascular disease. There is little evidence on the optimal type, regimen and dose of HRT; patient preference for route and method of administration of each component of HRT must be considered when prescribing, as should contraceptive needs. In women with POI, physiological replacement of estrogen (and progesterone) is essential for their health, and the controversies that surround the use of HRT in postmenopausal women do not apply. LIMITATIONS, REASONS FOR CAUTION N/A. WIDER IMPLICATIONS New areas of study on HRT for women with POI should focus on life expectancy, quality of life and neurological function. Furthermore, randomized controlled trials comparing transdermal estradiol with oral estrogens with regard to efficacy, patient satisfaction and side effects are urgently needed. STUDY FUNDING/COMPETING INTERESTS The authors received no funding for the review. The costs for the development of the ESHRE guideline were covered by ESHRE. The authors have no conflicts of interest to disclose.

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Section: Resultsmentioning

confidence: 95%

HRT for women with premature ovarian insufficiency: a comprehensive review

Webber

Anderson

Davies

et al. 2017

Human Reproduction Open

106

117

View full text Add to dashboard Cite

show abstract

“…Women with POI should be informed that HRT has not been found to increase the risk of breast cancer before the age of natural menopause (Benetti-Pinto, et al, 2008, Soares, et al, 2010, Wu, et al, 2014.…”

Section: What Are the Risks Of Hormone Replacement Therapy?mentioning

confidence: 99%

ESHRE Guideline: management of women with premature ovarian insufficiency

et al. 2016

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“…The classification developed by Wolfe, based on mammographic patterns, has been widely used for classifying individual breast cancer risk [4,5] and, in previous studies, identifying determinants of mammographic density [11,12,24]. Breast size was measured, as the distance, to the nearest 0.1 cm, between the pectoralis muscle and nipple on the film and averaged between left and right breasts.…”

Section: Study Participantsmentioning

confidence: 99%

Lifecourse predictors of mammographic density: the Newcastle Thousand Families cohort Study

Pearce

Tennant

Mann

et al. 2011

Breast Cancer Res Treat

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Dense mammographic patterns are a strong predictor of breast cancer risk. Factors at differing stages of life have been linked to breast cancer risk, although rarely studied simultaneously. We aimed to investigate whether birth weight and factors later in life were associated with mammographic density in the Newcastle Thousand Families Study. The Study originally consisted of all 1142 babies born in May and June 1947 to mothers resident in Newcastle upon Tyne in Northern England. Detailed information was collected prospectively during childhood, including birth weight and socio-economic circumstances. At age 49-51 years, 574 study members completed a 'Health and Lifestyle' questionnaire. Of the 307 surviving women who returned these questionnaires, 199 returned a further questionnaire asking for details of routine mammographic screening, their reproductive and contraceptive history. Mammographic patterns were coded into Wolfe categories. This was analysed, by ordinal logistic regression, in relation to a range of variables at different stages of life. Increased standardised birth weight (odds ratio, OR 1.32 (95% CI 1.02-1.71) P = 0.03) was a significant independent predictor of higher density. Increasing body mass index (BMI) was predictive of lower density (OR 0.86 per Kg/m(2) (95% CI 0.81-0.92) P < 0.001), as was having reached menopause (OR, compared to pre- and peri-menopausal, 0.41 (95% CI 0.23-0.73) P = 0.002). Interactions were seen between menopausal status and both BMI and age at menarche (P = 0.06) on density, although for neither did the direction of association change. After adjustment for factors acting throughout life, we identified a significant association between standardised birth weight and density in adulthood, consistent with previous research suggesting that heavier babies have an increased risk of breast cancer in later life. We also confirmed associations between both BMI and menopausal status.

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Breast density in women with premature ovarian failure using hormone therapy

Abstract: Periods of hypoestrogenism followed by hormone therapy resulted in no changes in breast density in women with POF, compared with normally menstruating women of the same age.

Cited by 14 publications

References 24 publications

HRT for women with premature ovarian insufficiency: a comprehensive review

HRT for women with premature ovarian insufficiency: a comprehensive review

ESHRE Guideline: management of women with premature ovarian insufficiency

Lifecourse predictors of mammographic density: the Newcastle Thousand Families cohort Study

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