The effects of tamoxifen treatment on the endometrium.
OBJECTIVE
To investigate the association between tamoxifen and endometrial cancer.


BACKGROUND
Tamoxifen is a nonsteroidal antiestrogenic drug that has been used successfully for 15 years in the treatment of all stages of breast carcinoma. In light of the positive results, several studies are now being conducted to test prolonged tamoxifen treatment as a prophylaxis against breast cancer in high-risk women. Although tamoxifen was thought to have only a few side effects, reports indicate that it is associated with an increased incidence of proliferative and neoplastic changes in the endometrium. As the current trend is to administer tamoxifen for prolonged periods and for more indications, the detrimental effects on the endometrium have vast implications.


METHODS
Review of the current literature.


RESULTS
Tamoxifen treatment is associated with an increased incidence of proliferative and neoplastic changes in the endometrium, with a 1.3 to 7.5 relative risk of developing endometrial carcinoma.


CONCLUSIONS
The results of tamoxifen treatment in breast carcinoma override the risk of developing endometrial carcinoma. Any vaginal bleeding in women treated with tamoxifen should be investigated carefully and promptly. In the future it may be necessary to advise these women to undergo routine uterine cavity examination.
Daniel
Y
Y
Department of Obstetrics and Gynaecology A, Tel Aviv Sourasky Medical Center, Hakirya Maternity Hospital, Sackler Faculty of Medicine, Tel Aviv, University, Israel.
Inbar
M
M
Bar-Am
A
A
Peyser
M R
MR
Lessing
J B
JB
D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D016889:Endometrial Neoplasms / Q000139:chemically induced* / Q000473:pathology; D004717:Endometrium / Q000187:drug effects / Q000473:pathology*; D004965:Estrogen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D012306:Risk; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D004965:Estrogen Antagonists; D013629:Tamoxifen