High-grade endometrial carcinoma in tamoxifen-treated breast cancer patients.
OBJECTIVE
Several reports have associated tamoxifen administration with endometrial carcinoma. A retrospective study of the histologic features of uterine cancer in patients with a history of breast carcinoma was undertaken to determine the effect of treatment with tamoxifen.


METHODS
A computer search of the Yale-New Haven Hospital Tumor Registry from 1980 to 1990 identified 53 patients with a history of breast carcinoma who subsequently developed a malignant tumor of the uterine corpus.


RESULTS
Fifteen patients received tamoxifen for breast carcinoma and 38 did not. The mean ages of the two groups were not significantly different. The mean interval between detection of breast and endometrial cancers was 5 years in the tamoxifen group and 12 years in the nontreated group (P = .0023). Sixty-seven percent of patients in the tamoxifen group had poorly differentiated endometrioid carcinomas (including adenosquamous carcinoma) or carcinomas associated with poor outcome (eg, uterine papillary serous carcinoma, clear-cell carcinoma, or mixed müllerian tumor), as compared with 24% in the nontreated group (P = .03). Patients in the tamoxifen group were much more likely to die of endometrial cancer (33.3% v 2.6% of the nontreated group, P = .005).


CONCLUSIONS
From this retrospective study, it appears that women receiving tamoxifen as treatment for breast cancer who subsequently develop uterine cancer are at risk for high-grade endometrial cancers that have a poor prognosis. These findings also indicate that tamoxifen-associated uterine cancers may have a different basis from those associated with steroidal estrogen treatment.
Magriples
U
U
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06510.
Naftolin
F
F
Schwartz
P E
PE
Carcangiu
M L
ML
D000230:Adenocarcinoma / Q000139:chemically induced; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy*; D002291:Carcinoma, Papillary / Q000139:chemically induced; D016889:Endometrial Neoplasms / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000139:chemically induced; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000473:pathology; D012189:Retrospective Studies; D012509:Sarcoma / Q000139:chemically induced; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use
D013629:Tamoxifen