J Korean Soc Menopause.  2010 Aug;16(2):79-85.

Impact of Medroxyprogesterone Acetate by Type of Combined Oral Estrogen on Mammographic Density in Korean Postmenopausal Women

• Lee DY
• Choi HJ
• Choi DS
• Min YK
• Choe YH
• Yoon BK

Abstract

OBJECTIVES
We determined if the impact of medroxyprogesterone acetate (MPA) co-administered with conjugated equine estrogen (CEE) or estropipate differed on mammographic density (MMGD) in Korean postmenopausal women.
METHODS
In this retrospective study, 53 healthy postmenopausal women without prior hormone therapy (HT) use were included. Smokers, habitual drinkers, women with a body mass index > or = 27 kg/m2, and women with a history of mammoplasty or breast cancer were excluded. HT using MPA (n = 26) consisted of the following two groups: CEE (n = 10) and estropipate (n = 16). Twenty-seven untreated women served as the control group. Mammography was obtained at baseline and 1 year later, and MMGD was assessed based on the breast imaging reporting and data system (BI-RADS) by one radiologist who was blinded to treatment. In addition, the change in the proportion of the dense area after HT was assessed using the J-image program. Data were analyzed with analysis of variance and chi-square or Fisher's exact test.
RESULTS
There were no significant differences in baseline clinical characteristics and MMGD among the three groups. After 1 year of HT, CEE (7/10 [70%]; P < 0.001) and estropipate (3/16 [18.8%]; P = 0.002) regimens significantly elevated the BI-RADS grade compared with controls (0%), and CEE induced a greater increase in MMGD than estropipate (P = 0.033). In addition, the proportion of dense areas assessed using the J-image program increased more with the CEE regimen (7.67%) than the estropipate regimen (1.48%), but there was no statistically significant difference.
CONCLUSION
Estropipate + MPA had a less stimulating effect on MMGD than CEE + MPA in Korean postmenopausal women. The change in MMGD induced with MPA might depend on the oral estrogen preparation. A further study on breast cancer risk based on combination HT is warranted.

Keyword

Estropipate; Conjugated equine estrogen; Mammographic density

MeSH Terms

Body Mass Index
Breast
Breast Neoplasms
Estrogens
Estrone
Female
Humans
Information Systems
Mammaplasty
Mammary Glands, Human
Mammography
Medroxyprogesterone
Medroxyprogesterone Acetate
Retrospective Studies
Breast Neoplasms
Estrogens
Estrone
Mammary Glands, Human
Medroxyprogesterone
Medroxyprogesterone Acetate