Breast enhanced scintigraphy testing distinguishes between normal, inflammatory breast changes, and breast cancer: a prospective analysis and comparison with mammography

What Effect, if any, does Soy Protein have on Breast Tissue?

Differences in breast tissue can be determined using breast-enhanced scintigraphy test (BEST) imaging. Minimal work in vivo has been done previously to determine the effects of soy protein on breast tissue. The authors' earlier work demonstrated reduction in inflammatory changes in breast tissue. This work was conducted to examine the effect of daily soy protein consumption on a larger group of women over the course of 1 year. Sixty-four premenopausal women were studied after initial BEST imaging evaluation revealed fibrocystic changes of the breast. Women were asked to consume a medical-grade soy protein on a daily basis, making no other dietary or lifestyle changes during that time. Each woman underwent BEST imaging 1 year later with the results compared to the initial findings. Women and their physicians reported a subjective reduction in both breast tenderness and fibrocystic disease (FCD). There was a nonstatistical reduction in both the average and maximal count breast activity following 1 year of daily soy consumption. There was a statistically significant reduction ( P< .01) in variability of tissue activity following 1 year of soy protein treatment. This is the first in vivo study looking at the effect of soy protein on breast tissue health. The findings are promising and showed both objective and subjective findings consistent with a reduction in fibrocystic disease of the breast. Further research is needed to confirm these findings in a greater number of women and to determine if soy protein has the same beneficial effect in atypia and breast cancer.

Do Women taking Hormone Replacement Therapy (HRT) have a Higher Incidence of Breast Cancer than Women who do not?

An estimated one third of all American and United Kingdom women take hormone therapy. In sharp contrast to these numbers, as many as one half of women diagnosed with breast cancer have taken hormones. Little additional information is available regarding the risk of breast cancer and even less is known about the association between hormone therapy and fibrocystic (FCD) disease or atypia of the breast. Three hundred women between 30 and 50 years of age were enrolled in this study, including 120 taking hormone replacement (HRT) therapy and 180 women who had never taken hormone therapy. These women were divided into four categories including those with normal breast tissue, those with FCD disease, those with cellular atypia, and those with breast cancer. Another group of women were also identified who had breast implants. Using breast enhanced scintigraphy (BEST) imaging, changes in breast tissue were determined and compared according to the use of HRT. Forty percent (122 of 300) had “normal” breasts, of whom 68.8% (84 of 122) did not take HRT. This accounted for 46.7% (84 of 180) of the women not taking hormone therapy, while only 31.7% (38 of 120) of the women taking HRT had normal breasts. This difference was statistically (p.001) significant. There was a greater incidence of breast abnormality in women taking HRT and a lower incidence in pathology among women not taking HRT when cumulatively analyzed for FCD, cellular atypia, and breast cancer. This difference was statistically significant (p.001) for women with breast cancer where 62.5% (10 of 16) were women taking HRT. Although the study was relatively small, it is the first such study to compare a continuum of changes in breast tissue according to the use of HRT. The study suggests that the initial empirical observations regarding higher incidence of HRT among women with breast cancer, may have a relationship to underlying changes in breast tissue that are associated with differences in mitochondrial content and activity. Further investigation is needed.

Are there differences in breast tissue as a result of hormone replacement therapy? Can BEST imaging distinguish these differences?

Although it has been speculated that estrogen therapy may promote changes in breast tissue that could lead to cancer, no information exists as to differences in breast tissue for women who do and do not take hormone replacement (HRT) therapy. This study seeks to determine if there are differences in the tissue of women taking HRT in contrast to those who do not and if these differences are apparent in cases of breast cancer, cellular atypia, fibrocystic (FCD) disease and normal breasts. A total of 327 non-pregnant, non-lactating, pre-menopausal women were enrolled in the study, including 139 women who were actively taking HRT and 188 women who never had taken HRT. Using breast enhanced scintigraphy test (BEST) imaging, differentiation of breast tissue was determined. The groups were then analyzed to determine the effect of hormone therapy within each category of breast tissue. Differentiation between normal, FCD, cellular atypia, and breast cancer represent statistically significant differences (p.001) in metabolic activity and vascularity as demonstrated by differences in both average count activity (ACA) and maximal count activity (MCA). The distinction between cellular atypia and infiltrating breast cancer was statistically (p.05) different when looking at the maximal activity. Normal breast tissue and breasts with FCD appear more homogenous with no statistical differences in variability in breast tissue. Tissue variability is statistically greater when localized processes, such as cellular atypia and breast cancer, are present. Differentiation of cellular metabolic activity in breast tissue can be statistically determined when looking at the average and maximal metabolic activity. The final distinction between cellular atypia and cancer occurs when a focal region of breast tissue becomes metabolically more active than the surrounding breast tissue as shown by statistical increases in MCA. These findings are confirmed by the increased metabolic variability seen in regions of cellular atypia and cancer compared with the homogenous metabolic activity present in normal and fibrocystic breasts.