Ultrasound Characteristics of Breast Changes in Albanian Postmenopausal Women Who use Hormonal Replacement Therapy

"BACKGROUND: HRT has been widely used in Albania, but it seems its importance has been raising lately. Many women are opting for this treatment as soon as menopause onset is diagnosed. It wasn’t until late though, that gynecologist started referring women for regular breast ultrasound after hormonal replacement therapy began. The aim of this study was identifying changes in breasts of postmenopausal women who had been under HRT, using sonography. MATERIALS: This is a retrospective study, based on datas gathered from women who were referred to us by gynecologist.All women were under cyclic regimen HRT. From all 165 women, only datas for 150 patients are included in this report. The 15 women excluded from the study, had either insufficient records or had been diagnosed with suspicious lesions since the first visit and were sent for further investigation. Once a year, for 6 consecutive years, breast ultrasonography was performed, and lesions were described using BIRAD-S lexicon. Patient’s datas were completed with careful anamnestic detailes time after time, and with hormonal and biochemical analysis. RESULTS: After HRT, we noticed that breast glandular section thickness had increased while breast ducts had became smaller. We were able to identify solid breast lesion ex novo in 8.7% and cysts in 2%. Reported serum estradiol levels in the 3rd year were quite higher in women who had marked structural changes opposed to the ones who didn’t experience such morphological change. These differences were significant in the 6th year of therapy. CONCLUSIONS : Starting HRT , leads to many changes in breast structure, which afterword need careful sonography assessment. An increasing percentage of the glandular tissue was reported from the first examinations untill the 6th year. In subjects with such change we can also monitor a raising level of estrogen. The use of ultrasound , is after all successful in determining breast structure changes and early identification of breast solid lesions or cysts. Therefore, we recommand annual follow-ups in all women, specially if under HRT."