title: [Tamoxifen and endometrial disease in patients with breast cancer].
abstract: The objectives were to evaluate prevalence of endometrial disease in patients treated with tamoxifen (TAM) and analyze the epidemiological, sonographic, hysteroscopic and histopathological findings. From January 1999 to December 2008, 152 breast cancer patients treated with TAM (20 mg/day), symptomatic (with bleeding) or asymptomatic, pre-and postmenopausal, were included consecutively in a prospective and observational follow-up study. Diagnostic methods were (TV) transvaginal ultrasound, hysteroscopy and curettage biopsy. TV ultrasound was performed every 12 months for 12 to 60 months. The patients' age were 62.76 years ± 10.24 the TAM-time: 36.24 ± 19. Adenocarcinoma was observed in 3/87 patients (3.45%) with risk factors and in 1/65 (1.54%) without them (RA 1.91, IC 95% 1.88-1.94). We found benign disease in 148 patients (97.37%) and adenocarcinomas in 4 (2.63%), one within a polyp. The 4 adenocarcinomas were detected in postmenopausal women (2 asymptomatic) with endometrial thicknesses equal or greater than 16 mm. The cancer risk was significantly increased in symptomatic (2.36 versus 0.42 in asymptomatic). Three adenocarcinomas were observed between 24 and 48 months of treatment. In conclusion, we suggest an adequate transvaginal ultrasound monitoring of asymptomatic patients treated with TAM, with removal of polyps, because atypia can be present hidden within, considering risk factors and exposure time. We suggest as an acceptable cut-off = 10 mm in asymptomatic postmenopausal patients.
authors.affiliation: Servicio de Ginecología, Hospital Nacional Prof. Dr. Alejandro Posadas, Buenos Aires, Argentina. dbdalbert@yahoo.com.ar
authors.forename: Delia B
authors.initials: DB
authors.lastname: Dalbert
authors.forename: Margarita M
authors.initials: MM
authors.lastname: Rodríguez de la Peña
authors.forename: Alicia
authors.initials: A
authors.lastname: Figueredo
authors.forename: Juan
authors.initials: J
authors.lastname: Mural
authors.forename: Ofelia
authors.initials: O
authors.lastname: Bartt
authors.forename: Ramiro
authors.initials: R
authors.lastname: Subiela
authors.forename: Carlos
authors.initials: C
authors.lastname: Rossi
authors.forename: Graciela
authors.initials: G
authors.lastname: Bazán
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy*; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D011127:Polyps / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology; D017698:Postmenopause; D011446:Prospective Studies; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013629:Tamoxifen / Q000009:adverse effects*; D014591:Uterine Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology*
chemical_list: D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen
keywords: breast cancer; endometrial disease; tamoxifen