Predictors of Breast Discomfort Among Women Initiating Menopausal Hormone Therapy

Overview

Journal Menopause

Specialty Gynecology & Obstetrics

Date 2009 Dec 17

PMID 20009961

Citations 1

Authors

Carolyn J Crandall

Daniela Markovic

Mei-Hua Huang

Gail A Greendale

Affiliations

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Abstract

Objective: The aim of this study was to analyze the determinants of breast discomfort among postmenopausal women initiating menopausal hormone therapy (HT).

Methods: We analyzed questionnaire, anthropometric, and serum estrone data from the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial, a randomized trial comparing placebo, conjugated equine estrogens (CEE) alone, or CEE with a progestogen (continuous or cyclical medroxyprogesterone acetate or cyclical micronized progesterone) among postmenopausal women. HT users could join the PEPI Trial after stopping HT for 2 months. We modeled the relation between smoking, body weight, alcohol consumption, age, quitting HT for the PEPI Trial, physical activity, and alpha-tocopherol consumption and new-onset breast discomfort at the 12-month follow-up among 662 participants without baseline breast discomfort.

Results: The associations of new-onset breast discomfort with weight and with strenuous exercise varied by treatment assignment. Among women assigned to CEE + progestogen, strenuous exercise was associated with a 49% lower odds of new-onset breast discomfort (odds ratio, 0.51; 95% CI, 0.29-0.89; P = 0.02), whereas among women assigned to placebo or CEE alone, strenuous exercise was not significantly associated with new-onset breast discomfort. Surprisingly, among women taking CEE alone, each kilogram higher weight was associated with a 6% lower odds of new-onset breast discomfort (P = 0.04), whereas among women taking placebo, the association was in the opposite direction (P = 0.04). Adjustment for estrone level had negligible effects on odds ratios. alpha-Tocopherol intake, age, smoking, and alcohol intake were not significantly associated with new-onset breast discomfort in adjusted analyses.

Conclusions: Strenuous exercise and higher body weight may decrease the odds of new-onset breast discomfort among postmenopausal women initiating HT.

Citing Articles

Breast tenderness and breast cancer risk in the estrogen plus progestin and estrogen-alone women's health initiative clinical trials.

Crandall C, Aragaki A, Cauley J, McTiernan A, Manson J, Anderson G Breast Cancer Res Treat. 2011; 132(1):275-85.

PMID: 22042371 PMC: 3697872. DOI: 10.1007/s10549-011-1848-9.

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