A. Ender YUMRU, Murat BOZKURT, Nuh GÜMÜŞTEKİN, Y. Tahsin AYANOĞLU

Hormon replasman tedavisinin mamografik paranikim dansitesi üzerine etkisi

Amaç: Yapılan çalışmada Hormon Replasman Tedavisi (HRT) alan hastalarda parankimal dansite değişikliklerinin, HRT ile olan ilişkisi, bu tedavi rejimleri ile artan dansite miktarının tayinini ve farklı hormon preparatları kullanan postmenopozal hasta gruplarının mamografik parankimal dansite değişikliklerinin karşılaştırılması amaçlandı. Materyal ve Metod: Çalışmaya 05.01.1999- 1.3.2003 tarihleri arasında Taksim Eğitim ve Araştırma Hastanesi menopoz polikliniğine başvuran ve menopoz tanısı konulan 82 hasta dahil edildi. 32 hastaya TAH+BSO operasyonu uygulanmıştı. Bu grup kontinu estrojen tedavisi almaktaydı. Gruplardan diğerleri değişik hormon replasman tedavi rejimleri almaktaydılar. 10 gruba ayrılan hastaların her yıl çekilen mamografi kontrolleriyle parankimal dansite değişimleri incelendi. Bulgular: HRT alan hastaların mamografik parankim dansite sonuçları Wolfe klasifikasyonuna göre değerlendirildi. Mamogfafik dansite artışı %24.3 (n:20). Mamografik dansite azalışı %7.3 (n:6). Mamografiik dansitesi sabit olanlar %68.2 (n:56) olarak bulundu, (not: n hasta sayısını gösterir.) Kontinu estrojen tedavisi alan (Climara tts, premarin ve estrofem oral tab) grupta dansite artışı %25 (n:8), azalma %3.1 (n:1), sabit kalma %71.8 (n:23) olarak bulundu. Estrojen ve progesteron kombine kontinu HRT alan grupta dansite artışı %41.6 (n:10), azalma %0 (n:0), sabit kalma %58.3(n:14) olarak bulundu. Tibolon (Livial oral tablet) kullanan grupta dansite artışı %7.6 (n:2), dansitede azalma %19.2 (n:5), sabit kalma %73 (n:19) olarak bulundu. Sonuç: Çalışmamızda mamografik parankimal dansitenin en fazla arttığı grup kontinu estrojen+progesteron kullanan hastalardı. Bu grupta dansite artışı %41.6 oranında idi. Tibolon kullanan grupta bu oran %7.6 ile en düşük bulunmuştur.

Anahtar Kelimeler:

Mammografi, Menopoz, Östrojen replasman tedavisi, Hormon replasman tedavisi

The effect of hormone replacement treatment to mammographic parenchyma density

Aim: In this study the aims are to determine the relation between, parenchymal density varieties and hormone replacement treatment (HRT) among the patients who receive HRT, to count the increase of density with this treatment regime, and to compare the mammographic density varieties among postmenopausal patient groups that use different hormone preparats. Material and Methods: A study design was used with 82 patients who applied to menopause policlinic of Taksim Education and Research Hospital and who were diagnosed as having menopause there between 05.01.1999 and 01.03.2003. One of the groups was constituted by 32 patients who were operated with TAH+BSO. This group received continuous estrogen treatment. The others were divided into groups according to different hormone replacement regimes. Every year the parenchymal density varieties of the patients was analyzed with mammography by dividing into 10 groups. Signs: These results are determined according to Wolfe classification among all the patients who receive HRT: Mammographic density increase %24.3 (n:20) Mammographic density decrease %7.3 (n:6) Stabil mammographic density %68.2 (n:56) (note:'n'means number) The results of the patients who received continuous estrogen treatment (Climara tts, premarin and estrofem oral tab) are: %25 increase (n:8), %3.1 decrease (n:1), %71.8 stabil (n:83). The results of the group who received continuous estrogen and progesterone combined HRT are: %41.6 increase (n: 10), %0 decrease (n:0), %58.3 stabil (n: 14). The results of the group who received tibolon (Livial oral tab.) are: %7.6 increase (n:2), %19.2 decrease (n:5), %73 stabil (n:19). Results: In our study, the group which reported the most increasing mammographic parenchymal density was the group which received combined estrogen and progesterone. In this group density increasing was %41.6 ratio. The lowest increasing density level was reported with the group which received Tibolon and ratio was %7.6.

Keywords:

Mammography, Menopause, Estrogen Replacement Therapy, Hormone Replacement Therapy,

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