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Hormone therapy use and mammographic density in postmenopausal Norwegian women

  • Epidemiology
  • Published:
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Abstract

While studies have shown that use of postmenopausal hormone therapy with estrogen and progestogen (EPT) increases mammographic density, aspects of this association remain unclear. We examined whether mammographic density differed by type of hormone therapy (HT) used, dose, duration of use, time since last use, and whether the effects are modified by age and body mass index (BMI). Using a cross-sectional design, we recruited 2,424 postmenopausal women aged 50–69 years participating in the Norwegian Breast Cancer Screening Program. Mammographic density was assessed with a computer-assisted method, and we estimated mean absolute and percent mammographic density through multiple linear regression, and adjusting for possible confounders. Mammographic density was higher among current HT users (percent density: 22.6%; 95% CI: 22.1–23.2%) than among former (17.7%; 17.2–18.2%) or never users (16.3%; 15.7–16.8%). The highest density was seen in current EPT users of high-dose norethisterone acetate (NETA) regimens who had a percent density of 26.2% (24.3–28.1%). Results differed when considering the combined effect of age and BMI. The effect of EPT on mammographic density was modified by age and BMI, with no apparent association among the youngest women (aged 50–55) with the highest BMI (BMI ≥ 26). A higher mammographic density was found in EPT users compared to never HT users, particularly in women using high-dose NETA regimens. Age and BMI modified the association between EPT use and mammographic density.

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Abbreviations

EPT:

Estrogen and progestogen

HT:

Hormone therapy

BMI:

Body mass index

PD:

Percent density

NETA:

Norethisterone acetate

ET:

Estrogen-alone regimens

NBCSP:

Norwegian breast cancer screening program

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Acknowledgments

This project was funded by the Norwegian Research Council and the Norwegian Cancer Society. The contribution of Prof. Steinar Tretli and Dr. Bjarte Ågnes is gratefully acknowledged.

Conflict of interests

The authors declare that they have no conflict of interests.

Author information

Authors and Affiliations

  1. Department of Nutrition, University of Oslo, Oslo, Norway

    Elisabeth Couto, Samera Azeem Qureshi, Marit Hilsen & Giske Ursin

  2. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden

    Elisabeth Couto

  3. Cancer Registry of Norway, Postboks 5313 Majorstuen, 0304, Oslo, Norway

    Elisabeth Couto, Solveig Hofvind & Giske Ursin

  4. Oslo University College, Oslo, Norway

    Solveig Hofvind

  5. Haukeland University Hospital, Bergen, Norway

    Hildegunn Aase

  6. Oslo University Hospital Ullevål, Oslo, Norway

    Per Skaane

  7. Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway

    Lars Vatten

  8. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Giske Ursin

Authors
  1. Elisabeth Couto
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  2. Samera Azeem Qureshi
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Correspondence to Giske Ursin.

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Couto, E., Qureshi, S.A., Hofvind, S. et al. Hormone therapy use and mammographic density in postmenopausal Norwegian women. Breast Cancer Res Treat 132, 297–305 (2012). https://doi.org/10.1007/s10549-011-1810-x

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  • DOI: https://doi.org/10.1007/s10549-011-1810-x

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