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Hormonal Variations in the Vascularity of Breast Tissue

Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania USA (S.P.W., E.F.C., C.M.S., J.A.P.); and Department of Radiology, Crozer Chester Medical Center, Upland, Pennsylvania USA (I.P.W.).

Address correspondence and reprint requests to Susan P. Weinstein, MD, Department of Radiology, University of Pennsylvania Medical Center, 1 Silverstein Bldg, 3400 Spruce St, Philadelphia, PA 19104 USA.

Objective. The purpose of this study was to determine whether there are sonographically detectable variations in breast glandularity and vascularity due to hormonal changes during the course of a normal menstrual cycle. Methods. Gray scale and color and power Doppler sonographic evaluations were performed on 7 premenopausal patients over the course of 1 menstrual cycle. Progesterone and estradiol levels were measured from saliva collected from the patients. Vascularity was measured by mean color level, area covered by color pixels, and color-weighted fractional area. Results. Of the 5 volunteers not taking oral contraceptives, 4 had peaks in vascularity correlating with midcycle peak hormonal levels (50%–320% from baseline) on power Doppler sonography. On color Doppler sonography, 3 of 5 patients also had peaks in vascularity (60%–190% from baseline). The 2 patients taking oral contraceptives did not have any peaks in vascularity. Conclusions. Vascularity changes in normal breast tissue that correlated with peak hormonal levels were detected in most of the volunteers. Therefore, hormonal variations in breast vascularity should be considered when evaluating breast lesions by sonography.

Key Words: breast • sonography • vascularity

Abbreviations: CWFA, color-weighted fractional area • FA, fractional area • MCL, mean color level • OCP, oral contraceptive