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Breast screening and HRT

A systematic review of the relationship between Hormone Replacement Therapy (HRT) use and the effectiveness of mammography concluded that women using HRT are more likely to receive false negative screening results and are also more likely to receive a false positive recall.1

However, the results of these studies had not been adjusted for crucial confounding factors such as age of the woman and menopausal status; the author of the review concluded that the size of the effect could not be estimated with confidence.

Results from the Million Women study – a large prospective study of women attending breast screening in the UK – show that current users of HRT are 64% more likely to receive a false positive recall than never users.2

According to results from the same study, sensitivity of mammography (the proportion of breast tumours diagnosed within 12 months of screening detected through screening) is nine percentage points lower in current HRT users than in never users (83% versus 92%).3

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References for breast screening and HRT

1. Banks, E., Hormone replacement therapy and the sensitivity and specificity of breast cancer screening: a review. J Med Screen, 2001. 8(1): p. 29-34.
2. Banks E, Reeves G, Beral V, et al. Hormone replacement therapy and false positive recall in the Million Women Study: patterns of use, hormonal constituents and consistency of effect. Breast Cancer Res 2006;8(1):R8.
3. Banks E, Reeves G, Beral V, et al. Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study. BMJ 2004;329(7464):477.

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