Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

A break from hormone therapy doesn't improve mammograms

02.06.2009
But postmenopausal hormone timeout lessens breast density in Annals trial

Some women take a short break from using postmenopausal hormone therapy before getting their breasts screened for cancer with mammography. They hope to lower their risk of being called back afterward for unnecessary extra breast imaging.

But taking a short break from hormones doesn't actually work for this purpose, according to the first large-scale randomized controlled trial to address the question. The READ (Radiological Evaluation and Breast Density) trial of more than 1,700 Group Health women is in the June 2, 2009 Annals of Internal Medicine.

"Postmenopausal hormones make breasts denser—like young women's breasts—and make mammograms harder to 'read,'" explained Diana S.M. Buist, PhD, MPH, an associate investigator at Group Health Center for Health Studies in Seattle. This raises the chance of having a "false-positive." That means women are called back ("recalled") for more testing, only to learn they have no breast cancer after all.

"False-positives account for a quarter of the overall costs of mammography in the United States," Buist said. Previous evidence showed stopping hormones could improve mammography, which led some clinicians to suggest stopping briefly before a mammogram. But there was no evidence of how long women needed to stay off hormones for their mammograms to improve. "We thought it was important to see if stopping hormones for one or two months really did make any difference in clinical outcomes," she said. "And we also wanted to make sure that it didn't cause any harm."

It didn't work in practice, according to the READ trial. The trial's three groups did not differ significantly in what proportion was called back for more tests after screening mammography. Of the women (aged 45-80) who stayed on hormone therapy, 11.3% were called back for more tests, compared to 12.3% and 9.8%, respectively, of those who stayed off hormones for one or two months. Taking a break from hormone therapy was not without harm: increasing the women's menopause symptoms. But there was also some benefit—making their breasts slightly less dense.

What does breast density mean? Breast tissue is composed mainly of milk glands and fat. A breast is dense if it consists of more milk glands than fat. Dense breast tissue, like milk glands, is denser and looks white on an X-ray, making tumors harder to see. That's why any tumors are harder to detect on mammograms of denser breasts than on those of less dense breasts. Breast density tends to decline with age, but individual women differ in the density of their breasts. Aside from age, having dense breasts is the biggest risk factor for breast cancer.

"We really hoped to find that a brief break in hormone therapy would lower false-positives and remove unnecessary costs and anxiety by improving mammography," Buist said. "And we were disappointed to find that it didn't. But we'll keep trying to find ways to reduce recall rates for women—in hopes of making mammography more effective and ensuring women have to go through the least amount of testing and radiation that's necessary."

The READ trial is part of Group Health's ongoing research on the comparative effectiveness of tests, treatments, and preventive actions—and figuring out which ones work and which don't in real clinical settings. "These types of studies are being called for increasingly as America and policy makers think about how to reform our health care system," Buist said. "Studies like this are important for making sure that we are basing medicine on evidence and providing the most effective health care."

"This study does not change our clinical message to doctors or patients about hormone therapy," said Buist.

"After our trial, as before it, women should engage in shared decision making with their doctors about whether or not to take hormones for their menopause symptoms—and if so, for how long," added Buist's co-author Susan D. Reed, MD, MPH. "Even women who find hormone therapy helps their symptoms should reassess yearly whether to continue hormone therapy," added Reed, a professor of obstetrics and gynecology at the University of Washington and an affiliate investigator at Group Health Center for Health Studies.

The Department of Defense funded the READ trial, which enrolled women from Group Health's Breast Cancer Screening Program.

Buist and Reed's READ trial co-authors were Juleann C. Gandara, MD, of Group Health; and Katherine M. Newton, PhD; Erin J. Aiello Bowles, MPH; Melissa L. Anderson, MS; E. Dawn Fitzgibbons, MPH; and Deborah Seger of Group Health Center for Health Studies.

Group Health Center for Health Studies

Founded in 1947, Group Health Cooperative is a Seattle-based, consumer-governed, nonprofit health care system that coordinates care and coverage. Group Health Center for Health Studies is Group Health's research institute. For 25 years, the Center has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding.

Rebecca Hughes | EurekAlert!
Further information:
http://www.ghc.org

More articles from Studies and Analyses:

nachricht Real-time feedback helps save energy and water
08.02.2017 | Otto-Friedrich-Universität Bamberg

nachricht The Great Unknown: Risk-Taking Behavior in Adolescents
19.01.2017 | Max-Planck-Institut für Bildungsforschung

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Stingless bees have their nests protected by soldiers

24.02.2017 | Life Sciences

New risk factors for anxiety disorders

24.02.2017 | Life Sciences

MWC 2017: 5G Capital Berlin

24.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>