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CONTEXT: Mammographic density is a strong independent risk factor for breast cancer, whose prevalence in acromegaly is still controversial. OBJECTIVE: To compare breast density in premenopausal acromegalic patients and controls and to determine whether density correlated with disease duration, GH, and IGF1 levels. DESIGN, SETTING AND PARTICIPANTS: A prospective study involving 30 patients and 60 controls matched for age and body mass index. INTERVENTIONS: A quantitative computer-aided mammographic density estimation (MDEST) and a qualitative blind evaluation by two experienced radiologists using the breast imaging reporting and data system (BI-RADS) was performed. Totally, 60 (acromegaly) and 120 (controls) craniocaudal and mediolateral oblique mammograms were evaluated in both patients and controls. MAIN OUTCOME MEASURES: Breast density. RESULTS: Patients showed a significantly (P<0.01) increased mammographic breast density with both methods (MDEST: 0.33±0.21% and BI-RADS category: 2.81±0.78) in comparison with controls (MDEST: 0.26±0.19% and BI-RADS category: 2.35±0.61). The agreement between the two methods and inter-observer agreement between the two radiologists were excellent (k=0.63 and k=0.85). In patients grouped according to disease activity (17 controlled and 13 uncontrolled) and medical therapy (15 treated and 15 untreated), no differences were found. All these groups had significantly increased mammographic breast density compared with controls (P<0.01). A positive correlation was found between mammographic breast density, IGF1 values and disease duration (r=0.29 and r=0.39), whereas it was not found with GH (r=–0.02). CONCLUSIONS: Mammographic breast density in premenopausal acromegalic patients is significantly higher than controls and positively correlated with IGF1 and disease duration. [ABSTRACT FROM AUTHOR]

CONTEXT: Acromegalic patients may complain of sensory disturbances in their hands. Cubital tunnel syndrome, the ulnar nerve neuropathy at the cubital tunnel (UCT), in acromegalic patients has never been reported. OBJECTIVE: To describe and assess the prevalence of UCT in acromegalic patients and the effects of 1 year of therapy on UCT. PATIENTS: We examined prospectively 37 acromegalic patients with no history of polyneuropathy, acute trauma at the elbow, no diabetes or hypothyroidism with clinical examination, nerve conduction studies (NCS), and high-resolution ultrasound (US). A control group was made by 50 volunteers. The local ethics committee approved the study and written informed consent was obtained from all subjects involved in the study. INTERVENTION: Clinical history, physical examination, NCS, and US were used to diagnose UCT at the beginning of the study and after 1 year. RESULTS: In 8 of 37 patients, a diagnosis of UCT was made at the beginning of the study reflecting a prevalence of 21%. After 1 year, 5 of 8 (62.5%) patients reported clinical and NCS improvements and evident US reduction of nerve cross-sectional area (CSA; 16.7±2.9 mm2vs 12.2±3.1 mm2; P<0.001). In 3 of 8 (37.5%) patients, the UCT was unchanged. Ulnar nerve CSA was significantly increased in acromegalic patients with UCT (16.7±2.9 mm2vs 11.1±2.3 mm2; P<0.047). CONCLUSION: Ulnar neuropathy could occur in acromegalic patients and can improve in 62% of cases with disease control. Due to the different management and therapeutic approach, it would be important to make differential diagnosis between cubital and carpal tunnel syndrome in acromegaly. [ABSTRACT FROM AUTHOR]