title: Evaluation of mammographic density and (99m)Tc-sestamibi scintimammographic uptake in postmenopausal women on hormone replacement therapy.
abstract: OBJECTIVE
  To evaluate changes in mammographic density and (99m)Tc-sestamibi scintimammographic uptake in postmenopausal women on hormone replacement therapy (HRT).
  
  
  METHODS
  Seventy-five postmenopausal women were prospectively studied and allocated into three groups: 50 women were randomized to either Group 1 (G1, n=25), which received 2mg of 17beta-oestradiol continuously combined with 1mg of norethisterone acetate (E2/NETA, Kliogest, Medley) or Group 2 (G2), which received 2.5mg/day of tibolone (Livial, Organon). The remaining 25 women, who were asymptomatic and had no desire to undergo HRT, constituted the control group (G3). Each patient was submitted to both mammography and scintimammography at baseline and after six months. Mammographic density was evaluated by using the BI-RADS classification system. The classification system of Barros et al. was used in the interpretation of scintimammography. For statistical analysis, the Chi-square test, ANOVA and Pearson's correlation were used.
  
  
  RESULTS
  At six months, increased mammographic density was observed in 48% of G1, 12% of G2 and 16% of G3 patients (p<0.001). The increase in sestamibi uptake was 56% in G1, 28% in G2 and 24% in G3 (p<0.001). Increases in both density and uptake were significantly higher in the group on E2/NETA than among tibolone users and the controls.
  
  
  CONCLUSIONS
  In postmenopausal women, HRT with E2/NETA was associated with increased mammographic density and increased (99m)Tc-sestamibi scintimammographic uptakes, suggesting greater mithochondrial activity in the cells of the mammary duct. This was not observed in users of 2.5 mg of tibolone, demonstrating that the effects on the breast were reduced. The same was observed in the control group.
authors.affiliation: Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP-São Paulo State University, Rubião Júnior, Botucatu, São Paulo 18618-970, Brazil. epetri@fmb.unesp.br
authors.forename: Jorge
authors.initials: J
authors.lastname: Nahas-Neto
authors.forename: Laurival A De
authors.initials: LA
authors.lastname: Luca
authors.forename: Beatriz Lotufo
authors.initials: BL
authors.lastname: Griva
authors.forename: José
authors.initials: J
authors.lastname: Morceli
authors.forename: Eliana Aguiar Petri
authors.initials: EA
authors.lastname: Nahas
authors.forename: Sônia Marta
authors.initials: SM
authors.lastname: Moriguchi
authors.forename: Gilberto
authors.initials: G
authors.lastname: Uemura
authors.forename: Paulo
authors.initials: P
authors.lastname: Traiman
mesh_terms: D001940:Breast / Q000000981:diagnostic imaging / Q000187:drug effects*; D016009:Chi-Square Distribution; D004958:Estradiol / Q000008:administration & dosage / Q000494:pharmacology*; D020847:Estrogen Receptor Modulators / Q000008:administration & dosage / Q000494:pharmacology*; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D000077563:Norethindrone Acetate; D009652:Norpregnenes / Q000008:administration & dosage / Q000494:pharmacology*; D017698:Postmenopause; D011446:Prospective Studies; D011877:Radionuclide Imaging
chemical_list: D020847:Estrogen Receptor Modulators; D009652:Norpregnenes; D004958:Estradiol; D000077563:Norethindrone Acetate; C027385:tibolone; D009640:Norethindrone