Endocrine Abstracts

Aim: It is hypotethically thought that increased frequency of breast cancer in patients with primary hyperparathyroidism(PHPT)may be due to the fact that calcium accumulation in the breast may be higher in patients with PHPT giving rise to more breast-related examinations. Although there are many studies or case reports showing calcification in many organs and tissues, in PHPT, there is not any study investigating breast calcification in these patients in the literature. We aimed to determine the frequency and features of breast calcification and distribution of BI-RADS scores in patients with PHPT.

Method: Female patients ≥40 years old with PHPT and and age-matched healthy women were included. Demographical, antropometric and laboratory findings were noted. Mammography was performed in all patients and controls. Calcification types and BIRADS scores were recorded. Clustered microcalcification, ductal calcification, linear thin or segmental calcification were considered suspicious calcification. Skin calcification, scattered, punctate, vascular calcification and macrocalcification were termed as benign calcification. Two groups were compared in terms of demographical, laboratory findings, presence of calcification, calcification types and BI-RADS in mammography. Patients were divided in two groups according to the duration of PHPT as less or more than 48 months.

Results: Sixty-one patients and 75 control were enrolled. While age distribution was similar(57.0±7.9 vs 55±7.5, P=0.153), body mass index was higher in patient group(32.4±6.7 vs 29.2±6.2 kg/m², P=0.005). Median duration of PHPT was 46(1-85) months. BI-RADS score was comparable and the most frequent score was BIRADS-0. Presence of breast calcification and calcification types were not different in two groups. Demographical, laboratory and mammographic findings are summarized in table. Presence of calcification was similar in PHPT patients with disease duration of less and more than 48 months. There was not any cut-off for disease duration that can predict presence of calcification. Of the 3 patients(all was with PHPT)who underwent excisional breast biopsy, one resulted in invasive breast ca, one as atypical ductal hyperplasia, and the other as benign.

Conclusion: Female patients with PHPT did not have an increased incidence of breast calcification compared to healthy women, suggesting that calcification is not responsible for the increased incidence of breast cancer in these patients. Distribution of BI-RADS scores was also not affected by the presence of PHPT.