Hormonal Influences on ADC Values in Breast Tissues: A Scoping Review of DWI in Pre- and Post-menopausal Women

Background: Breast cancer remains a significant global health concern, with early diagnosis and risk factor identification crucial for improving outcomes. Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) measurements have emerged as promising tools in breast cancer diagnostics. However, the influence of hormonal status on these measurements remains unclear. Objective: This scoping review aims to synthesize current evidence on how hormonal changes in pre- and post-menopausal women influence ADC values of benign, malignant, and fibroglandular breast tissues. Method: Following the Arksey and O’Malley framework, we conducted a comprehensive search of Scopus, Embase, and PubMed databases for relevant studies published between January 2000 and 2021. Inclusion criteria encompassed 1.5 Tesla MRI studies reporting ADC values in female subjects, considering menopausal status. Results: Six studies meeting the inclusion criteria, involving 612 patients, were analyzed. Findings suggest that menopausal status may influence ADC values, with postmenopausal women generally showing lower ADC values in both normal fibroglandular tissue and breast lesions. The impact of menstrual cycle phases on ADC values was less consistent across studies. Conclusions: This review highlights the potential influence of hormonal status on ADC values in breast tissues. While DWI with ADC mapping shows promise as a reliable diagnostic tool across different hormonal states, further research is needed to fully understand and account for hormonal influences on ADC measurements. Future studies should focus on longitudinal designs, standardization of DWI protocols, and integration of hormonal status information into breast cancer risk assessment models.