Abstract：Objective To explore the correlation between menopausal hormone therapy（MHT）and breast lesions in perimenopausal women,and to provide evidence for safe use of MHT. Methods The 40-60 year-old women who visited Hangzhou Women's Hospital and met the diagnostic criteria for perimenopausal syndrome were recruited. The intervention group received MHT and was divided into three subgroups according to the MHT regimen：estrogen-progesterone cycle therapy（A）,estrogen-progesterone continuous therapy（B）,estrogen therapy（C）. The control group did not receive MHT. All the patients received regular mammography to quantify and evaluate breast lesions. The generalized estimating equation was used to analyze the changes of breast lesions between different groups. Results There were 80 cases in the intervention group,with 49 in group A,26 in group B,5 in group C,and 80 cases in the control group. After two years of follow-up,there was no statistically significant differences of time,group and interaction in breast density,volume of breast fibrous tissue and the volume of breast between three intervention groups and the control group（P>0.05）; there was no statistically significant differences of group and interaction in positive rate of calcification and breast mass between the intervention group and the control group（P>0.05）. Conclusion Receiving MHT intervention for two years did not increase the risk of breast lesions.
THORLEY J.HRT for menopause:a delicate balance[J]. Lancet Diabetes Endocrinol,2016,4:25.
HOLM J,HUMPHREYS K,LI J,et al.Risk factors and tumor characteristics of interval cancers by mammographic density[J]. J Clin Oncol,2015,33(9):1030-1037.
DAYE D,KELLER B,CONANT E F,et al.Mammographic parenchymal patterns as an imaging marker of endogenous hormonal exposure:a preliminary study in a high-risk population[J]. Acad Radiol,2013,20(5):635-646.
DAVEY D A.Menopausal hormone therapy:a better and safer future[J]. Climacteric,2018,21(5):454-461.
SEIFERT-KLAUS V,KINGSWELLS E,HITCHCOCK C L,et al.Estrogen and progestogen use in peri- and postmenopausal women:March 2007 position statement of The North American Menopause Society[J]. Menopause,2008,15(1):203-206.
PINES A.Hormone therapy and breast cancer:the press-release version of WHI study data[J]. Climacteric,2013,16(2):222-225.
WOOLCOTT C G,CONROY S M,NAGATA C,et al.Methods for assessing and representing mammographic density:an analysis of 4 case-control studies[J]. Am J Epidemiol,2014,179(2):236-244.
MCTIERNAN A,MARTIN CF,PECK JD,et al.Estrogen- plus-progestin use and mammographic density in postmenopausal women:Women's Health Initiative randomized trial[J]. J Natl Cancer Inst,2005,97(18):1366-1376.
SENDAG F,COSAN-TEREK M,OZSENER S,et al.Mammographic density changes during different postmenopausal hormone replacement therapies[J]. Fertil Steril,2001,76(3):445-450.
MARTIN L J,MINKINS S,BOYD N F.Hormone therapy,mammographic density,and breast cancer risk[J]. Maturities,2009, 64(1):20-26.
KOTSOPOULSO J,GRONWALD J,KALAN B Y,et al.Hormone replacement therapy after oophorectomy and breast cancer risk among BRCAI mutation carriers[J]. JAMA Oncol,2018,4(8):1059-1065.
STUTE P,WILDT L,NEULEN J.The impact of micronized progesterone on breast cancer risk:a systematic review[J]. Climacteric,2018,21(2):111-122.