Effect of ultra-low-dose transdermal estradiol on breast density in postmenopausal women

University of California, San Francisco, San Francisco, California, United States
Menopause (Impact Factor: 3.36). 05/2007; 14(3 Pt 1):391-6. DOI: 10.1097/01.gme.0000236939.81819.6c
Source: PubMed


Women with higher mammographic breast density have increased risk for breast cancer, and there is some evidence that a change in breast density may be a marker for change in risk for breast cancer. The purpose of this study was to determine whether 2 years of treatment with ultra-low-dose transdermal estradiol results in a change in breast density.
The Ultra-Low-dose Transdermal Estradiol Assessment was a randomized, blinded, placebo-controlled trial of 2 years of treatment with unopposed ultra-low-dose (0.014 mg/d) transdermal estradiol for prevention of osteoporosis in 417 postmenopausal women with no history of breast cancer who had not had a hysterectomy. We obtained mammograms at baseline and after 1 and 2 years of treatment from 276 of the participants. Right craniocaudal views were analyzed at a central radiology facility by a trained clinician blinded to treatment group and order of acquisition. Contour analysis was performed to define dense areas versus fatty tissue. Between-group differences in mean change in percent breast density from baseline to 1 and to 2 years of follow-up were assessed using linear regression models adjusted for clinical site.
Participants were 66 +/- 5 years old and 94% were white. The average percent breast density at baseline was 34%. There was no significant difference between treatment groups in change in percent breast density after 1 year (between-group difference, 0.1%; 95% confidence interval, -1.3% to 1.6%) or 2 years of treatment (0.8%; -0.6% to 2.1%).
Two years of treatment with ultra-low-dose transdermal estradiol did not increase breast density.

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    • "mg oral conjugated equine estrogens (CEE) or 25–50 ␮g transdermal estradiol daily. There is evidence from observational data that lower estrogen dose may have a lesser impact on mammographic density [23] [24], stroke [25] and VTE [26] "
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