European Radiology

, Volume 28, Issue 8, pp 3176–3184 | Cite as

Mammographic density changes following discontinuation of tamoxifen in premenopausal women with oestrogen receptor-positive breast cancer

  • Won Hwa Kim
  • Nariya Cho
  • Young-Seon Kim
  • Ann Yi



To evaluate the changes in mammographic density after tamoxifen discontinuation in premenopausal women with oestrogen receptor-positive breast cancers and the underlying factors


A total of 213 consecutive premenopausal women with breast cancer who received tamoxifen treatment after curative surgery and underwent three mammograms (baseline, after tamoxifen treatment, after tamoxifen discontinuation) were included. Changes in mammographic density after tamoxifen discontinuation were assessed qualitatively (decrease, no change, or increase) by two readers and measured quantitatively by semi-automated software. The association between % density change and clinicopathological factors was evaluated using univariate and multivariate regression analyses.


After tamoxifen discontinuation, a mammographic density increase was observed in 31.9% (68/213, reader 1) to 22.1% (47/213, reader 2) by qualitative assessment, with a mean density increase of 1.8% by quantitative assessment compared to density before tamoxifen discontinuation. In multivariate analysis, younger age (≤ 39 years) and greater % density decline after tamoxifen treatment (≥ 17.0%) were independent factors associated with density change after tamoxifen discontinuation (p < .001 and p = .003, respectively).


Tamoxifen discontinuation was associated with mammographic density change with a mean density increase of 1.8%, which was associated with younger age and greater density change after tamoxifen treatment.

Key Points

• Increased mammographic density after tamoxifen discontinuation can occur in premenopausal women.

• Mean density increase after tamoxifen discontinuation was 1.8%.

• Density increase is associated with age and density decrease after tamoxifen.


Breast density Mammography Tamoxifen Receptors, Oestrogen Prognosis 



This study has received funding by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (NRF-2014R1A1A2053682).

Compliance with ethical standards


The scientific guarantor of this publication is Nariya Cho.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional review board approval was obtained.

Informed consent

Written informed consent was waived by the institutional review board.


• retrospective

• observational

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of RadiologySeoul National University HospitalSeoulRepublic of Korea
  2. 2.Department of RadiologyKyungpook National University Chilgok HospitalDaeguRepublic of Korea
  3. 3.Department of RadiologySeoul National College of MedicineSeoulRepublic of Korea
  4. 4.Institute of Radiation MedicineSeoul National University Medical Research CenterSeoulRepublic of Korea
  5. 5.Department of Radiology, College of MedicineYeungnam UniversityDaeguRepublic of Korea
  6. 6.Department of RadiologyGangnam Healthcare CenterSeoulRepublic of Korea

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