Increased mammographic breast density in acromegaly: quantitative and qualitative assessment.

Context: mammographic density is a strong independent risk factors for breast cancer, whose prevalence in acromegaly is still controversial. Objective: to compare breast density in premenopausal acromegalic patients and controls and to determine whether density correlated with disease duration, GH and IGF-I levels. Design, Setting, and Participants: prospective study involving 30 patients and 60 controls matched for age and BMI. Interventions: a quantitative computer-aided mammographic density estimation (MDEST) and a qualitative blind evaluation by two experienced radiologists using the BI-RADS have been performed. Sixty (acomegaly) and 120 (controls) craniocaudal (CC) and mediolateral oblique (MLO) mammograms were evaluated in both patients and controls. Main Outcome Measures: breast density Results: patients showed a significantly (p<0.01) increased mammographic breast density with both methods [MDEST 0.33 ± 0.21%; BI-RADS category 2.81 ± 0.78] in comparison to controls [MDEST 0.26 ± 0.19%; BI-RADS category 2.35 ± 0.61]. The agreement between the two methods and inter-observer agreement between the two radiologists were excellent (k=0.63 and k=0.85). In patients, grouped according disease activity (17 controlled; 13 uncontrolled) and medical therapy (15 treated; 15 untreated), no differences were found. All these groups had significantly increased mammographic breast density compared to controls (p<0.01). A positive correlation was found between mammographic breast density, IGF-I values and disease duration (r=0.29 and r=0.39), whereas not with GH (r=-0.02). Conclusions: mammographic breast density in premenopausal acromegalic patients is significantly higher than controls and positively correlated with IGF-I and disease duration.