Mammographic breast density, hormones, and growth factors during continuous combined hormone therapy

Fertil Steril. 2004 Jun;81(6):1617-23. doi: 10.1016/j.fertnstert.2004.02.096.


Objective: To study the effect on mammographic breast density of two different continuous combined regimens for hormone therapy.

Design: Randomized clinical study.

Setting: University hospital.

Patient(s): Postmenopausal women without any previous history of breast disorder.

Intervention(s): The women received either estradiol valerate/dienogest or estradiol/norethisterone acetate. Mammograms and venous blood samples were obtained at baseline and after 6 months.

Main outcome measure(s): Change in mammographic breast density. Correlations with levels of hormones, growth factors, and binding proteins.

Result(s): An increase in mammographic density was recorded in approximately 50% of the women, and there were no differences between treatments. Increased density showed a positive correlation with estradiol, estrone, and sex hormone-binding globulin and showed a negative association to free T. Among hormonal factors, levels of free T were the most important for predicting increased density.

Conclusion(s): Continuous combined hormone therapy with different progestogens has a marked impact on the breast.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast / drug effects
  • Estradiol / administration & dosage
  • Estradiol / blood
  • Estrogen Replacement Therapy*
  • Estrone / blood
  • Female
  • Growth Substances / blood*
  • Hormones / blood*
  • Humans
  • Mammography*
  • Nandrolone / administration & dosage
  • Nandrolone / analogs & derivatives*
  • Norethindrone / administration & dosage
  • Norethindrone / analogs & derivatives*
  • Norethindrone Acetate
  • Sex Hormone-Binding Globulin / metabolism
  • Testosterone / blood


  • Growth Substances
  • Hormones
  • Sex Hormone-Binding Globulin
  • Estrone
  • Testosterone
  • dienogest
  • Estradiol
  • Nandrolone
  • Norethindrone Acetate
  • Norethindrone