Tamoxifen effects on endometrium.
BACKGROUND
To evaluate the effects on the endometrium of a long term treatment with Tamoxifen in postmenopausal patients, asymptomatic for gynecologic disorders, surgically treated for breast cancer.


METHODS



METHODS
Outpatient menopausal clinic and endoscopic unit.


METHODS
45 patients (Group I) were treated with 20 mg of Tamoxifen daily for a mean of 23.4 months. Seven patients (Group II) represented the control group and did not receive Tamoxifen. A transvaginal ultrasonography and a hysteroscopic guided biopsy were performed in all patients.


RESULTS
Sagittal sonograms showed abnormal endometrial thickening (range 8-32 mm, mean 13 mm) in 17 patients (35.4%) of Group I and in 1 patient of Group II. Pathology on endometrial tissue sampling obtained at the time of hysteroscopy showed hyperplastic endometrial polyps in 3 patients (6.25%), endometrial hyperplasia in 16 patients (33.4%), while 1 patient had an endometrial polyp cancer on a background of hyperplasia and 1 had a superficial endometrial cancer (4.1%). Out of the 7 patients of Group II, one had an endometrial polyp, while 6 had no relevant endometrial abnormalities.


CONCLUSIONS
Our study confirms that Tamoxifen treatment is associated with an increased incidence of proliferative and neoplastic endometrial changes. No obvious correlation was found between the length of Tamoxifen exposure time and occurrence of endometrial pathologies. It is mandatory to undertake twice per year gynecological evaluations for patients treated with Tamoxifen to promptly identify and correctly manage endometrial changes.
Colacurci
N
N
Institute of Obstetrics and Gynaecology, Second University of Naples School of Medicine, Italy. def69dot@hotmail.com
De Seta
L
L
De Franciscis
P
P
Mele
D
D
Fortunato
N
N
Cassese
S
S
D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery; D016889:Endometrial Neoplasms / Q000139:chemically induced; D004717:Endometrium / Q000187:drug effects*; D004965:Estrogen Antagonists / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D013629:Tamoxifen / Q000009:adverse effects*
D004965:Estrogen Antagonists; D013629:Tamoxifen