title: Tamoxifen associated uterine pathology in breast cancer patients with abnormal bleeding.
abstract: The purpose of this study was to evaluate the underlying pathology in breast cancer patients treated with tamoxifen who present with abnormal bleeding. A total of 56 cases were studied and the histopathologic features of 50 curettage and 18 laparotomy specimens were reviewed. All patients were under tamoxifen treatment (10-40 mg daily) for a period ranging from 5 months to 15 years. Cervical and endometrial polyps were the most common finding in the D and C material (44%). Hyperplasia was the most frequent feature identified at hysterectomy, often combined with leiomyomas, adenomyosis and ovarian tumors. Five primary adenocarcinomas of the endometrium, most of them Stage I beta, Grade I minimally invading, were found as well. These data support the hypothesis that tamoxifen exerts a proliferative estrogen-like effect on the uterus. Abnormal bleeding in women under TAM treatment warrants prompt investigation and careful follow up of the patients.
authors.affiliation: Department of Gynecology, Saint Savas Cancer Hospital of Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Fotiou
authors.forename: A
authors.initials: A
authors.lastname: Tserkezoglou
authors.forename: G
authors.initials: G
authors.lastname: Hadjieleftheriou
authors.forename: N
authors.initials: N
authors.lastname: Apostolikas
authors.forename: I
authors.initials: I
authors.lastname: Karydas
authors.forename: K
authors.initials: K
authors.lastname: Stravolemos
mesh_terms: D000230:Adenocarcinoma / Q000139:chemically induced; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D004714:Endometrial Hyperplasia / Q000139:chemically induced; D016889:Endometrial Neoplasms / Q000139:chemically induced; D005260:Female; D006801:Humans; D008875:Middle Aged; D011127:Polyps / Q000139:chemically induced; D012189:Retrospective Studies; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014591:Uterine Diseases / Q000139:chemically induced*; D014592:Uterine Hemorrhage / Q000139:chemically induced*
chemical_list: D013629:Tamoxifen