In the article published by Susan Davis and colleagues in the [i]Journal of Clinical Endocrinology & Metabolism[/i] of December 2009, the authors compared the effects of two doses of the testosterone transdermal patch (TTP) with placebo on mammographic density in postmenopausal women without concomitant estrogen/progestin therapy (EPT) over a period of 52 weeks .
Greater mammographic density is associated with increased breast cancer risk and reduced diagnostic mammographic sensitivity, as in the case in women receiving EPT. However, the effects of testosterone therapy on mammographic density in postmenopausal women on EPT are not known.
The study was a randomized, double-blind, placebo-controlled, parallel-group, multinational trial. Patients included 279 postmenopausal women randomized to placebo, or TTP at 150 μg/day, or TTP at 300 μg/day, stratified by menopause type (natural or surgical). A total of 250 women with paired mammograms for study at baseline and at termination (at week 52) were included in the primary analysis. There were no baseline differences between the groups. The mean changes from baseline (± SEM) in percentage of dense tissue for the placebo, TTP 150, and TTP 300 groups were small (0.05% ± 0.16, 0.06% ± 0.19, and 0.21% ± 0.17, respectively) and were not significantly different. Also, there were no statistically significant differences from placebo for total dense or non-dense area and no significant relationship between hormone levels and percentage of dense tissue after adjustment for body mass index.
TTP therapy over 52 weeks appears to have no significant effect on digitally quantified absolute or percent dense mammographic area in postmenopausal women not using EPT.
Roberto Sano Ito
Internal Medicine and Infectious Diseases, President of the Peruvian Menopause Society
Davis SR, Hirschberg AL, Wagner LK, Lodhi I, von Schoultz B. The effect of transdermal testosterone on mammographic density in postmenopausal women not receiving systemic estrogen therapy. J Clin Endocrinol Metab 2009;94:4907-13.
Hofling M, Lundstrom E, Azavedo E, et al. Testosterone addiction during menopausal hormone therapy: effects on mammographic breast density. Climacteric 2007;10:155-63.
Birkhuser H, Panay N, Archer DF, et al. Updated practical recommendations for hormone replacement therapy in peri- and postmenopause. Climacteric 2008;11:108-23.
Somboonporn W, Davis SR; National Health and Medical Research Council. Testosterone effects on the breast: implications for testosterone therapy for women. Endocr Rev 2004;25:374-88.