Health  Vol.5 No.7 D , July 2013
Retrospective study of MRI images to examine the effects of estrogen supplementation on breast tissue: A pilot study in Asian Taiwan

MRI provides a highly sensitive technique for early detection of abnormal breast tissue. It is useful for identifying a status of proliferation, angiogenesis, and microvascular permeability, which may indicate early breast neoplasm formation. We retrospectively studied 2005 breast MRI images from Taiwanese women and classified them as either healthy or unhealthy according to BI-RADS categories. A subgroup of our study patients had received estrogen supplements, containing estrogen components or phytoestrogen, for at least 3 months. These patients’ images were also classified into the healthy and unhealthy groups. These two groups were compared and a significant difference was found between them (P < 0.002). Comparison of the MRI images also identified certain cases that demonstrated a typical estrogen/phytoestrogen effect or a withdrawal effect. The overuse of estrogen or phytoestrogen supplements can increase breast glandular tissue proliferation, as reflected on MRI images. Such proliferation may increase the patient’s risk of future breast cancer.

Cite this paper: Leung, T. , Huang, P. , Wu, C. , Lee, C. , Hung, C. , Liang, H. and Chiou, J. (2013) Retrospective study of MRI images to examine the effects of estrogen supplementation on breast tissue: A pilot study in Asian Taiwan. Health, 5, 105-109. doi: 10.4236/health.2013.57A4015.

[1]   Katalinic, A. and Rawal, R. (2008) Epidemiology decline in breast cancer incidence after decrease in utilisation of hormone replacement therapy. Breast Cancer Research Treatment, 107, 427-430. doi:10.1007/s10549-007-9566-z

[2]   Leung, T.K., Huang, P.J., Chen, C.S., Lin, Y.H., Wu, C.H. and Lee, C.M. (2010) Is breast MRI screening more effective than digital mammography in Asian women? Journal of Experimental & Clinical Medicine, 2, 245-250. doi:10.1016/S1878-3317(10)60038-1

[3]   Erguvan-Dogan, B., Whitman, G.J., Kushwaha, A.C., Phelps, M.J. and Dempsey, P.J. (2006) BI-RADS-MRI: A primer. American Journal of Roentgenology, 187, W152-W160. doi:10.2214/AJR.05.0572

[4]   Stephens, T.W. (1998) Illustrated breast imaging reporting and data system (BI-RADS). 3rd Edition, American College of Radiology, Reston.

[5]   Liberman, L. and Menell, J.H. (2002) Breast imaging reporting and data system (BI-RADS). Radiologic Clinics of North America, 40, 409-430. doi:10.1016/S0033-8389(01)00017-3

[6]   Leung, T.K., Chu, J.S., Huang, P.J., Lee, C.M., Lin, Y.H., Chen, C.S., Tai, C.J. and Wu, C.H. (2010) Breast MRI for monitoring images of an “adenomyoepithelioma with malignant features”, before, during, and after chemotherapy. Breast Journal, 16, 652-653. doi:10.1111/j.1524-4741.2010.01009.x

[7]   Leung, T.K., Huang, P.J., Lee, C.M., Chen, C.S., Wu, C.H. and Chao, J.S. (2010) Can breast magnetic resonance imaging demonstrate characteristic findings of preoperative ductal carcinoma in situ in Taiwanese women? Asian Journal of Surgery, 33, 143-149. doi:10.1016/S1015-9584(10)60024-3

[8]   Leung, T.K., Huang, P.J., Lee, C.M. and Chen, C.S. (2012) Silicone breast implant with intracapsular rupture coexisting with locally advanced carcinoma. Breast Journal, 18, 76-77. doi:10.1111/j.1524-4741.2011.01187.x

[9]   Key, T.J., Chen, J., Wang, D.Y., Pike, M.C. and Boreham, J. (1990) Sex hormones in women in rural China and in Britain. British Journal of Cancer, 62, 631-636. doi:10.1038/bjc.1990.344

[10]   Clemons, M. and Goss, P. (2001) Estrogen and the risk of breast cancer. New England Journal of Medicine, 344, 276-285. doi:10.1056/NEJM200101253440407

[11]   Tsai, A.C., Liou, J.C., Chang, M.C. and Chuang, Y.L. (2007) Influence of diet and physical activity on aging-associated body fatness and anthropometric changes in older Taiwanese. Nutrition Research, 27, 245-251. doi:10.1016/j.nutres.2007.03.002

[12]   Hsieh, S.C., Lai, J.N., Lee, C.F., Hu, F.C., Tseng, W.L. and Wang, J.D. (2008) The prescribing of Chinese herbal products in Taiwan: A cross-sectional analysis of the national health insurance reimbursement database. Pharmacoepidemiological Drug Safety, 17, 609-619. doi:10.1002/pds.1611

[13]   Dupont, W.D. and Page, D.L. (1985) Risk factors for breast cancer in women with proliferative breast disease. New England Journal of Medicine, 312, 146-151. doi:10.1056/NEJM198501173120303

[14]   Hsieh, C.Y., Santell, R.C., Haslam, S.Z. and Helferich, W.G. (1998) Estrogenic effects of genistein on the growth of estrogen receptor-positive human breast cancer (MCF7) cells in vitro and in vivo. Cancer Research, 58, 3833-3838.

[15]   Zava, D.T. and Duwe, G. (1997) Estrogenic and antiproliferative properties of genistein and other flavonoids in human breast cancer cells in vitro. Nutrition Cancer, 27, 31-40. doi:10.1080/01635589709514498

[16]   Wang, T.T., Sathyamoorthy, N. and Phang, J.M. (1996) Molecular effects of genistein on estrogen receptor mediated pathways. Carcinogenesis, 17, 271-275. doi:10.1093/carcin/17.2.271

[17]   Yager, J.D. and Davidson, N.E. (2006) Estrogen carcinogenesis in breast cancer. New England Journal of Medicine, 354, 270-282. doi:10.1056/NEJMra050776

[18]   Peeters, P.H.M., Keinan-Boker, L., van der Schouw, Y.T. and Grobbee, D.E. (2003) Phytoestrogens and breast cancer risk: Review of the epidemiological evidence. Breast Cancer Research Treatment, 77, 171-183. doi:10.1023/A:1021381101632

[19]   Keinan-Boker, L., van der Schouw, Y.T., Grobbee, D.E. and Peeters, P.H.M. (2004) Dietary phytoestrogens and breast cancer risk. American Journal of Clinical Nutrition, 79, 282-288.

[20]   Duffy, C., Perez, K. and Partridge, A. (2007) Implications of phytoestrogen intake for breast cancer. Ca-A Cancer Journal for Clinicians, 57, 260-277. doi:10.3322/CA.57.5.260

[21]   Bouker, K.B. and Hilakivi-Clarke, L. (2000) Genistein: Does it prevent or promote breast cancer? Environmental Health Perspectives, 108.

[22]   Mayo, J.L. (1997) A Natural approach to menopause. Clinical Nutrition Insights, 5, 1-8.

[23]   Huang, K.C. (1993) The pharmacology of Chinese herbs. CRC Press, Boca Raton.

[24]   Yapa, S.P., Shena, P., Lia, J., Leeb, L.S. and Yonga, E.L. (2007) Molecular and pharmacodynamic properties of estrogenic extracts from the traditional Chinese medicinal herb, Epimedium. Journal of Ethnopharmacology, 113, 218-224. doi:10.1016/j.jep.2007.05.029

[25]   Wang, Z.Q. and Lou, Y.J. (2004) Proliferation-stimulating effects of icaritin and desmethylicaritin in MCF-7 cells. European Journal of Pharmacology, 504, 147-153. doi:10.1016/j.ejphar.2004.10.002