Course Description
Hormone replacement therapy (HRT) is an effective treatment for symptoms of menopause.  Studies have shown HRT increases breast cancer risk and mammographic density. The risks of HRT differ depending on whether estrogen or estrogen plus progestin are used, the administered dose, age and timing of initiation, duration of use, route of administration, and individual patient's other risk factors.

Mammography is the mainstay of breast screening for women aged 40 and over but is less effective in women under 50 years of age and in women with dense breasts. Women with dense breasts are at increased risk of breast cancer independent of taking HRT. Cancers detected in women with dense breasts are larger, often node positive, and interval cancers are 18 times more likely to occur in women with dense breasts. High-risk populations  (women with a lifetime risk of greater than 20%-25%) are advised to undergo additional annual surveillance with magnetic resonance imaging (MRI) or, if they cannot undergo MRI, consider screening breast sonography. However, there is a gap in the approach to screening non-high risk or average high-risk women such as HRT users who span the spectrum of risk for breast cancer based on their individual profile. Given the prevalence of dense breast tissue and the challenges of identifying cancer in women with dense breasts using mammography, additional imaging modalities to detect mammographically occult breast cancer may be needed. Results of clinical trials on the use of HRT, recommendations for the use of HRT, the role of breast screening modalities, and the importance of individualized screening strategies will be reviewed.

Learning Objectives:
After reading this article, the participant should be able to:

• DESCRIBE the results of the Women's Health Initiative.
• EXPLAIN the impact of hormone replacement therapy on breast cancer risk and breast density.
• DISCUSS the role of imaging modalities for breast cancer screening in women taking hormone replacement therapy.

CE Information
In order to receive CE credit, you must first complete the activity content. When completed, go to the "Take CE Test!" link to access the post-test.

Submit the completed answers to determine if you have passed the post-test assessment. You must answer 6 out of 8 questions correctly to receive the CE credit. You will have no more than 3 attempts to successfully complete the post-test.

Participants successfully completing the activity content and passing the post-test will receive 1.0 ARRT Category A credit.

Approved by the American Society of Radiologic Technologists for ARRT Category A credit.

Approved by the state of Florida for ARRT Category A credit.

Texas direct credit.

This activity may be available in multiple formats or from different sponsors. ARRT does not allow CE activities such as Internet courses, home study programs, or directed readings to be repeated for CE credit in the same biennium.