Hormone Replacement Therapy and the Accuracy of Screening Mammography

The objective of our study was to assess the exact impact of hormone replacement therapy (HRT) in the screening program  that the Institut Municipal d’Assistència Sanitària (IMAS) is performing in four of  the ten districts of the city of Barcelona, Spain. We studied the round done between January 2000 and December 2002. A total of 30 073 women were screened. Through a ten minute interview, conducted to all screened women, information about menopause and HRT was obtained. A total of 22 795 women were included in the study, of whom 20 206 were non-HRT users and 2 577 were users (current or ever users). We found a statistically significant higher recall rate in users (6.9%) than in non users (5.6%), but we consider that this small difference (1.3%) has no clinical impact. No other differences were found in other parameters: use of invasive procedures, sensivity or cancer detection rate. 

Our conclusion after this study was that HRT slightly impacts our breast cancer screening, minimally increasing the recall rate. As no more invasive procedures are found in the HRT-users group, it is suggested that additional re-screening and ultrasound are enough to reach a definitive diagnosis in the “excess of women” recalled. Due to those minimal differences in the recall rate and the absence of differences in other important parameters (like cancer detection rate), we conclude that in our experience, women who are HRT-users continue to be candidates to attend breast cancer screening programs.  

Bibliographic reference:

Vernet M et al.: "Influence of Hormone Replacement Therapy on the Accuracy of Screening Mammography", The Breast Journal  2006;12:154-158

Maria del Mar Vernet Tomàs

Obstetrics and Gynaecology Department, Breast Cancer Unit, Hospital del Mar - IMAS, Barcelona, Spain