Incidence of malignancy in hormone therapy users with indeterminate calcifications on mammogram

Objective This was a pilot study to determine whether menopausal hormone therapy users have a higher incidence of indeterminate calcifications on screening mammogram and a higher rate of associated malignancy than nonusers. Study design A retrospective chart review of routine screening mammograms with indeterminate calcifications was conducted to determine the malignancy rate overall and in hormone therapy users and nonusers. A control group of normal screening mammograms was used to determine whether hormone therapy use was representative of the population that undergo screening mammograms and to compare the malignancy rates. Results The rates of hormone therapy use in the study and control groups were similar. The overall malignancy rate was 24.7%; no difference existed between users and nonusers. Comparing estrogen only with estrogen-progestin users demonstrated a malignancy rate of 5.8% and 17.6%, respectively (odds ratio 2.28). Conclusions Hormone therapy users with indeterminate calcifications on screening mammograms are not at an increased risk of malignancy than nonusers. Estrogen-progestin users may be at an increased risk over estrogen-only users.