Tamoxifen and ovarian cysts: a prospective study.
OBJECTIVE
To prospectively follow a group of women with breast cancer on tamoxifen for the development of ovarian cysts.


METHODS
72 women were followed every 6 months with pelvic examination and vaginal ultrasound. Chi square and Student's t-test were used for statistical analysis.


RESULTS
The duration of treatment was 31.5+/-20 months. The mean age was 51.2+/-9.8 years. 55.6% were post-menopausal. Out of 72 women, 18 (25%) developed ovarian cysts. The mean age of women who developed ovarian cysts was significantly lower than in those who did not (47.0+/-7.0 and 52.5+/-10.2 years, respectively, P=0.03), however, the mean duration of treatment was not significantly different (33.3+/-17.4 and 29.3+/-20 months, respectively, P=0.45). Out of 32, 14 (43.8%) pre-menopausal and out of 40, 4 (10%) post-menopausal women developed ovarian cysts (P=0.003). They developed the cysts after an average duration of 33.3+/-18 and 50.7+/-6.2 months, respectively (P=0.7). The average diameter of the cysts was 2.8+/-1.2 cm. All cysts were simple except for one pre-menopausal women. All the cysts in post-menopausal women resolved spontaneously. One pre-menopausal patient had a multi-loculated cyst, was operated and had a serious cystadenoma. In nine patients, the cysts resolved spontaneously and in three after discontinuation of tamoxifen, and one patient was lost to follow-up. All cysts were asymptomatic.


CONCLUSIONS
Ovarian cysts frequently develop in women with breast cancer on tamoxifen. The majority of the cysts resolve spontaneously, therefore an expectant management with follow-up ultrasonography is recommended.
Seoud
M
M
Department of Obstetrics and Gynecology, American University of Beirut, Medical Center, C/O NY Office, 850 Third Avenue, New York, NW 10022, USA. mike@aub.edu.lb
El-saghir
N
N
Salem
Z
Z
Shamseddine
A
A
Awwad
J
J
Medawar
W
W
Khalil
A
A
D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy; D004965:Estrogen Antagonists / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010048:Ovarian Cysts / Q000139:chemically induced* / Q000000981:diagnostic imaging; D017698:Postmenopause; D017697:Premenopause; D011446:Prospective Studies; D013629:Tamoxifen / Q000009:adverse effects*; D013997:Time Factors; D014463:Ultrasonography
D004965:Estrogen Antagonists; D013629:Tamoxifen