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To the Editor: Dr Rutter and colleagues¹ studied the relationship between initiating, continuing, and discontinuing hormone replacement therapy (HRT) and mammographic breast density. They found that HRT may increase breast density for some but not all women and that increases in breast density may make mammograms more difficult to interpret.

But this study does not assess whether this difficulty translates into poorer prognosis or clinically missed cancers. Previous studies have shown that there is no effect of HRT on mammographic sensitivity or breast cancer detection.^2-3 Others⁴ have found no significant differences in the numbers of mammographically detected cancers and false-negative mammograms between HRT users and nonusers.

It is well known that mammograms are less sensitive in younger women, whose breasts are typically more dense. As hormone levels decline after menopause, breast density decreases. For most women, HRT maintains the level of breast density at the time of initiation. Although HRT . . . [Full Text of this Article]

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RELATED ARTICLE

Changes in Breast Density Associated With Initiation, Discontinuation, and Continuing Use of Hormone Replacement Therapy
Carolyn M. Rutter, Margaret T. Mandelson, Mary B. Laya, and Stephen Taplin
JAMA. 2001;285(2):171-176.
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