Advertisement

Can tamoxifen cause a significant mammographic density change in breast parenchyma?

  • Orhan Konez
    Correspondence
    Corresponding author. Current address: Department of Radiology, Beth Israel Deaconess Medical Center 330 Brookline Avenue, Boston, MA 02215. Tel.: 617-667-2523; fax: 617-754-2545
    Affiliations
    Department of Radiology, Mercy Medical Center, Northeastern Ohio Universities College of Medicine (NEOUCOM), Mercy Dr. NW, Canton, OH 44708, USA

    Department of Radiology, Aultman Hospital, Northeastern Ohio Universities College of Medicine (NEOUCOM), Canton, OH, USA
    Search for articles by this author
  • Manish Goyal
    Footnotes
    Affiliations
    Department of Radiology, Mercy Medical Center, Northeastern Ohio Universities College of Medicine (NEOUCOM), Mercy Dr. NW, Canton, OH 44708, USA

    Department of Radiology, Aultman Hospital, Northeastern Ohio Universities College of Medicine (NEOUCOM), Canton, OH, USA
    Search for articles by this author
  • Robert E. Reaven
    Affiliations
    Department of Radiology, Mercy Medical Center, Northeastern Ohio Universities College of Medicine (NEOUCOM), Mercy Dr. NW, Canton, OH 44708, USA
    Search for articles by this author
  • Author Footnotes
    1 Current address: Saskatoon city hospital, Queen street, Saskatoon, SK, CANADA.

      Abstract

      To evaluate tamoxifen-induced glandular tissue density changes in women who are on an adjuvant tamoxifen therapy. We examined serial mammograms of 27 women (average age 67) who had surgery for unilateral breast carcinoma and were on tamoxifen for 5 years. Mammograms obtained at the beginning of treatment, within 2 or 3 years, at the end of 5 years and 1 year after cessation of tamoxifen treatment, were evaluated by two radiologists experienced in reading mammograms. Four 1-cm-diameter circular areas of the glandular tissue and retroglandular fat were sampled by a densitometer and a relative glandular density (glandular tissue/fat density) was used for comparison between serial mammograms. Most cases (79%) did not show tamoxifen-induced change in glandular density. Three patients (13%) showed an early and two (8%) a delayed mild reduction in glandular density as compared to baseline mammograms. No patient was found to have increased glandular density following the cessation of tamoxifen therapy (in subjective evaluation). Densitometer readings showed a mild reduction in glandular densities in 16 cases (60%) during treatment and a minimal increase in 13 cases (48%) following cessation of treatment. There was a slight decrease in breast density during treatment [relative density of 0.012±0.006 (standard error) per interval, P value: .06] and the difference between years 5 and 6 was nearly zero [relative density of 0.00042±0.01 (standard error), P value: .97]. Long-term use of tamoxifen may cause a mild reduction in breast glandular density, although this, in part, may be attributed to the age-related mammographic density change. Following cessation of tamoxifen, no significant increase in glandular density was observed. Therefore, any increase in mammographic density during or after tamoxifen treatment should be viewed with suspicion and further evaluated.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Peck DR
        • Lowman RM
        Estrogen and the postmenopausal breast. Mammographic considerations.
        JAMA, J Am Med Assoc. 1978; 240: 1733-1735
        • Stomper PC
        • Van Voorhis BJ
        • Ravnikar VA
        • Meyer JE
        Mammographic changes associated with postmenopausal hormone replacement therapy: a longitudinal study.
        Radiology. 1990; 174: 487-490
        • Berkowitz JE
        • Gatewood OMB
        • Goldblum LE
        • Gayler BW
        Hormonal replacement therapy: mammographic manifestations.
        Radiology. 1990; 174: 199-201
        • Meyer JE
        • Frenna TH
        • Polger M
        • Sonnenfeld MR
        • Shaffer K
        Enlarging occult fibroadenomas.
        Radiology. 1992; 183: 639-641
        • Rand T
        • Heytmanek G
        • Seifert M
        • Wunderbaldinger P
        • Kreuzer S
        • Schneider B
        • Wolf G
        Mammography in women undergoing hormone replacement therapy.
        Acta Radiol. 1997; 38: 228-231
        • Osborne CK
        Tamoxifen in the treatment of breast cancer.
        N Engl J Med. 1998; 339: 1609-1618
        • Dewar JA
        • Horobin JM
        • Preece PE
        • Tavendale R
        • Tunstall-Padoe H
        • Wood RA
        Long-term effects of tamoxifen on blood lipid values in breast cancer.
        Br Med J. 1992; 305: 225
        • Cuenca RE
        • Giachino J
        • Arredondo MA
        • Hempling R
        • Edge SB
        Endometrial carcinoma associated with breast carcinoma: Low incidence with tamoxifen use.
        Cancer. 1996; 77: 2058-2063
        • McDonald CC
        • Steward HJ
        • Scottish Breast Cancer Committee
        Fatal myocardial infarction in the Scottish adjuvant tamoxifen trial.
        Br Med J. 1991; 303: 435
        • Love RR
        • Mazess RB
        • Tormey DC
        • Barden HS
        • Newcomb PA
        • Jordan VC
        Bone mineral density in women with breast cancer treated with adjuvant tamoxifen for at least two years.
        Breast Cancer Res Treat. 1988; 12: 297
        • Ward RL
        • Morgan G
        • Dalley D
        • Kelly PJ
        Tamoxifen reduces bone turnover and prevents lumber spine and proximal femoral bone loss in early postmenopausal women.
        Bone Miner. 1993; 22: 87
        • Ursin G
        • Pike MC
        • Spicer DV
        • Porrath SA
        • Reitherman RW
        Can mammographic densities predict effects of tamoxifen on the breast?.
        J Natl Cancer Inst. 1996; 88: 128-129
        • Taylor C
        • Georgian-Smith D
        Regression of breast cancer in four patients treated with tamoxifen: mammographic features.
        AJR, Am J Roentgenol. 1994; 162: 613-616
        • Fisher B
        • Costantino J
        • Redmond C
        • Poisson R
        • Bowman D
        • Couture J
        • Dimitrov NV
        • Wolmark N
        • Wickerham DL
        • Fisher ER
        A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors.
        N Engl J Med. 1989; 320: 479-484
        • Fisher B
        • Dignam J
        • Bryant J
        • DeCillis A
        • Wickerham DL
        • Wolmark N
        • Costantino J
        • Redmond C
        • Fisher ER
        • Bowman DM
        • Deschenes L
        • Dimitrov NV
        • Margolese RG
        • Robidoux A
        • Shibata H
        • Terz J
        • Paterson AH
        • Feldman MI
        • Farrar W
        • Evans J
        • Lickley HL
        Five versus more than five years of tamoxifen therapy for breast cancer patients with negative lymph nodes and estrogen receptor-positive tumors.
        J Natl Cancer Inst. 1996; 88: 1529-1542
        • Hurst JL
        • Mega JF
        • Hogg JP
        Tamoxifen-induced regression of breast cysts.
        Clin Imaging. 1998; 22: 95-98