A realistic clinical perspective of tamoxifen and endometrial carcinogenesis.
Tamoxifen has been the endocrine treatment of choice for all stages of breast cancer for nearly a decade. Millions of women are currently receiving tamoxifen worldwide, while large-scale randomised trials have been launched aiming to investigate the drug's merit as a preventive agent. However, there are now concerns about tamoxifen's potential carcinogenicity. The goal of this review is to address these concerns, re-evaluate the available data from laboratory biological models and those from clinical reports and put the whole issue into perspective. Our focus is the association between tamoxifen and the increased frequency of endometrial tumours, while key issues, such as the role of duration of tamoxifen therapy, are also addressed. Finally, we discuss the various monitoring strategies for early detection of endometrial lesions and pertinent problems most likely to be encountered by clinicians taking care of patients who are receiving tamoxifen.
Robert H. Lurie Cancer Center, Northwestern University Medical School, Chicago Illinois, USA.
V J
VJ
Assikis
P
P
Neven
V C
VC
Jordan
I
I
Vergote
D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D015197:Carcinogenicity Tests; D016022:Case-Control Studies; D006224:Cricetinae; D004311:Double-Blind Method; D016889:Endometrial Neoplasms / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000139:chemically induced; D051379:Mice; D011127:Polyps / Q000139:chemically induced / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D051381:Rats; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen