DISTRIBUTION OF MAMMOGRAPHIC DENSITIES IN 5052 WOMEN AT THE PERIMENOPAUSAL AND POSTMENOPAUSAL STAGE

Aims: To establish the frequency and age distribution of breast tissue den- sity, mammographic masses and benign calcifications and to study the effect of hormone replacement therapy (HRT), which has been suggested to affect parenchymal density on mammograms. Methods: The mammograms of all patients attending the Zekai Tahir Burak Women Health Education and Research Hospital menopause clinic between January 2001 and January 2004 were evaluated. We reviewed 5052 women. The density for each breast was classified into one of four groups as defined by the BI-RADS system. For each patient, benign or probably benign calci- fications were also recorded. The use of HRT was recorded systematically for every patient. Chi-square and Spearman correlation tests were perfor- med. The statistical significance of observed differences was set at p<0.05. Results: In the evaluation of mammographic densities, 2246 (44.4%) of the 5052 patients had heterogeneously dense or extremely dense breasts. It is shown in this study that as age increases mammographic density progres- sively decreases. Mammographic masses thought to be malign are mostly seen in the upper external zone and central zone. HRT use increases paren- chymal density and decreases mammographic sensitivity. Conclusion: Mammography is the basic imaging modality for the evaluati- on of patients with breast abnormalities. The sensitivity of screening mam- mography decreases as parenchymal density increases. Benign calcificati- ons can be seen in any age group. There is no need for any further diagnostic approach for calcifications thought to be benign. Key Words: Mammographic density, Benign calcifications, Mass lesions. PERIMENOPOZAL VE POSTMENOPOZAL DONEMDEKI 5052 HASTANIN MAMOGRAFIK DANSITELERININ DAĞILIMI Amac: Mamografide saptanan kitlelerin, meme dansitesinin ve benign ozel- likteki kalsifikasyonlarin yaslara gore dagilimini ve sikliklarini saptamak ve HRT’nin meme dansitesi uzerindeki etkisini degerlendirmek. Metod: Ocak 2001 ve Ocak 2004 tarihleri arasinda Dr. Zekai Tahir Burak Kadin Sagligi Egitim ve Arastirma Hastanesi menapoz poliklinigine basvu- ran 5052 hastanin mamografileri degerlendirildi. Her meme dansitesi BI- RADS sistemine gore dort gruptan birinde olacak sekilde degerlendirildi. Hastalarda saptanan mamografik kitleleler ve benign ozellikteki kalsifikas- yonlar not edildi. Hastalarin HRT kullanma durumlari degerlendirildi. Ista- tistiksel incelemeler icin ki-kare ve Spearman korelasyon testleri kullanildi ve p<0.05 degeri istatistiksel anlamlilik olarak kabul edildi. Sonuclar: Mamografik dansitelerin degerlendirilmesinde 5052 hastanin 2246 tanesi (44,4%) heterojen dens veya dens memeye sahipti. Yas ilerle- dikce meme dansitesi azalmaktadir. Malign oldugu dusunulen mamografik kitleler en sik ust dis kadran ve santral bolgede yer almaktadir. HRT kulla- nimi dansiteyi artirirken mamografik sensitiviteyi azaltir. T artisma: Mamografi, meme rahatsizligi olan hastalarin degerlendirilme- sinde en temel yontemdir. Mamografinin sensitivitesi parankimal dansite arttikca azalmaktadir. Benign kalsifikasyonlar her yas grubunda gorulebil- mektedir, bunlar icin daha ileri inceleme yapilmasina gerek yoktur. Anahtar Sozcukler: Mamografik dansite, benign kalsifikasyon, kitle lez- yonu.