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Hormone Replacement May Halve Rate of Breast Arterial Calcification

Hormone replacement therapy can halve the incidence breast artery calcification, an effect which clinicians can pick up during normal mammogram screens.

The extent of breast calcification may indicate underlying vascular disease, and a risk factor for myocardial infarction and stroke, reports Dr Julie Cox and colleagues at the Department of Radiology, Freeman Hospital, Newcastle, England.

Easily detected on mammograms, arterial calcification in the female breast is common, but has uncertain clinical significance. It may, however, have importance as a vascular risk factor. The prevalence of breast arterial calcification (BAC) has been documented as between 9 and 12 percent in women over the age 50.

An increased incidence of BAC is associated with manifestations of vascular disease, including diabetes mellitus, systemic hypertension, myocardial infarction, transient ischaemic attack, and stroke. Hormone replacement therapy (HRT) is associated with a lower incidence of cardiovascular disease in postmenopausal women by as much as 50 percent.

In their study, the researchers assessed the influence of HRT on the prevalence of BAC in 4,400 women who had a breast cancer mammogram screen and found significantly increased levels of breast arterial calcification in women who had never used HRT compared with a group of women presently using HRT.

Artery calcification was seen in 530 women, or 12 percent of the total. The rate of breast artery calcification was just under 8 percent in those taking HRT, but 14 percent in those who had never used HRT.

Although breast calcification increases with age and allowing for this fact, women not using HRT had more than a 50 percent increased risk of breast calcification.

Dr Cox and colleagues conclude: "Our findings suggest that HRT reduces the risk of developing breast arterial calcification detect on breast screening mammograms, and give further support to the accumulated evidence that HRT s beneficial in reducing the incidence of cardiovascular disease."
Journal of Medical Screening 2002; 9: 38-39.

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