Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2016) 41 EP900 | DOI: 10.1530/endoabs.41.EP900

ECE2016 Eposter Presentations Pituitary - Clinical (83 abstracts)

Impact of the GH-receptor antagonist pegvisomant on mammographic breast density in postmenopausal acromegalic women

Ammar Muhammad 1 , Gianluca Ficarra 2 , Sanne Franck 1 , Elena Nazarri 2 , Alberto Tagliafico 2 , Sebastian Neggers 1 , Diego Ferone 2 & Federico Gatto 2

1Erasmus University Medical Center, Rotterdam, The Netherlands; 2University of Genova, Genova, Italy.

Background: Acromegaly is a severe systemic condition characterized by elevated circulating levels of growth hormone (GH) and insulin-like growth factor I (IGF-I) and increased mortality and morbidity. The role of GH and IGF-I in mammary hyperplasia is well established and GH/IGF-I elevation has been hypothesized to favor neoplastic development. We recently demonstrated that premenopausal females with active acromegaly may display an increased mammographic breast density (MBD) compared with healthy matched controls. In the present study, we aimed to evaluate the impact of treatment with the GH-receptor antagonist pegvisomant (PEGV) on MBD in postmenopausal acromegalic patients.

Patients and Methods: patients (mean age 59 yrs) with at least one mammogram available were evaluated. A second and a third mammogram was available in 29 and 27 patients. Clinical and biochemical characteristics at the time of the first and last mammogram were recorded. Mammograms were evaluated using a validated software (MDEST) which provides a quantitative assessment of MBD on a percentage scale.

Results: At first radiological evaluation, 12 patients were treated with long-acting somatostatin analogues (LA-SSAs) combined with PEGV and 27 with LA-SSAs alone. MBD was slightly lower in patients treated with LA-SSA and PEGV compared with patients on SSA monotherapy (0.29±0.15% vs. 0.24±0.09%, n.s.). Interestingly, MBD significantly decreased in the 7 patients with moderate-high breast density, which started PEGV treatment after the first radiological evaluation and performed a second and third mammogram in a 2 yrs time frame (0.43±0.13% vs. 0.29±0.8% vs. 0.26±0.5%, P=0.01).

Conclusions: The addition of PEGV to LA-SSA treatment in postmenopausal acromegalic patients with moderate-high MBD results in a significant decrease of MBD and could, therefore, reduce the risk of developing malignancy in these patients exposed to increased risk of breast cancer.

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