Case Number 3

By this time, concluding that therapeutic hormones were responsible for the unusual findings in these above cases, I surmised that a richer source of cases would be found in post menopausal patients on hormone replacement therapy. Between 1980 and my retirement in 1987, I found about 20 more cases which were examples of definite hormone "masking". I am certain that most of the negative mammograms in proven breast carcinoma are due to hormone "masking". Several of my cases will bear this out, one in particular I will relate. A post menopausal patient who was on Premarin noticed an indefinite mass in one breast. An internist in the Midwest ordered a mammogram which was negative. About 3 or 4 months later the patient moved to Florida and saw a new internist who obtained another mammogram which was also negative. He sent the patient to me and I told her that I thought she had a malignancy but that the estrogen was "masking" the mammogram and physical findings. Her biopsy was positive and a modified radical mastectomy revealed rather extensive malignancy in the breast with axillary metastases.