The effects of tamoxifen therapy on the endometrium.
From January 1992 to December 1998, 219 women (aged between 30 and 81 yrs; average 55 years) affected by breast cancer were treated. These women in addition to the usual adjuvant therapy, were treated with TAM 20 mg/day, for a period between 24 and 72 months (average 40). In this group there were 84 postmenopausal and 31 premenopausal women. In 8 fertile patients ovarian activity was suppressed with GnRh analogue therapy and one patient underwent attinic castration. Before performing TAM therapy, a hysteroscopic exam was done and patients were followed-up with an annual check-up. None had any endometrial side-effects after the first check-up. After two years, 31 women (26.9%) complained of endometrial alterations (hyperplasia, polyps and endometrial cancer). One women only after 6 years of follow-up, had metrorrhagia; an endometrial adenocarcinoma was found. We would like to point out the necessity of monitoring these patients with an annual check-up (transvaginal sonography and/or hysteroscopy).
Zarbo
G
G
2nd Institute of Obstetrics and Gynaecology, Catania University, Italy.
Caruso
G
G
Zammitti
M
M
Caruso
S
S
Zarbo
R
R
D000230:Adenocarcinoma / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D016889:Endometrial Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D004717:Endometrium / Q000187:drug effects / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy; D015994:Incidence; D008875:Middle Aged; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen