Aromatase inhibitor anastrozole for treating endometrial hyperplasia in obese postmenopausal women

Αγοραστός, Θεόδωρος; Vaitsi, Violetta; Pantazis, Konstantinos; Efstathiadis, E.; Vavilis, Dimitrios; Bontis, J.

doi:10.1016/j.ejogrb.2004.07.002

Cited by 42 publications

(19 citation statements)

References 3 publications

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“…Other studies carried out by Barker et al, Li et al, and Berstein et al on the cases of endometrial hyperplasia or adenocarcinoma revealed that letrozole was successful in decreasing endometrial thickness and stopping bleeding (27)(28)(29). Moreover, the same results were reported from using anastrozole, another aromatase inhibitor, for treatment of hyperplastic endometrium (30).…”

Section: Discussionsupporting

confidence: 69%

The Effect of Letrozole and Metformin on Endometrial Histology in Patients With Disordered Proliferative Endometrium

Ouladsahebmadarek¹,

Balali²,

Sayyah-Melli³

et al. 2017

International Journal of Women’s Health and Reproduction Scienc

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Section: Discussionsupporting

confidence: 69%

The Effect of Letrozole and Metformin on Endometrial Histology in Patients With Disordered Proliferative Endometrium

Ouladsahebmadarek¹,

Balali²,

Sayyah-Melli³

et al. 2017

International Journal of Women’s Health and Reproduction Scienc

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“…24). In addition, 12 months of anastrozole treatment in 11 obese postmenopausal women with endometrial hyperplasia resulted in an atrophic endometrium in all cases (25).…”

Section: Discussionmentioning

confidence: 99%

Anastrozole versus tamoxifen treatment in postmenopausal women with endocrine-responsive breast cancer and tamoxifen-induced endometrial pathology.

Gerber¹,

Krause²,

Reimer³

et al. 2006

Clinical Cancer Research

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Purpose:To investigate the effect of switching from adjuvant tamoxifen to anastrozole (Arimidex) treatment in postmenopausal women with endocrine-responsive breast cancer and histologically proven tamoxifen-induced benign endometrial pathology. Experimental Design: Two hundred twenty-six postmenopausal women who had received adjuvant tamoxifen 20 mg/d (z12 months, V48 months) and developed abnormal vaginal bleeding and/or an asymptomatic endometrial thickness >10 mm [measured by transvaginal ultrasound (TVUS)] were subjected to hysteroscopy and dilation and curettage (D&C). Thereafter, 171 patients were randomized in a phase III study to continue tamoxifen treatment (n = 88) or switch to anastrozole1mg/d (n = 83). Patients were monitored for V42 months usingTVUS at 6-monthly intervals. Results: At study entry, there were no significant differences in vaginal bleeding, endometrial thickness, and histologic findings between the two treatment groups. Throughout the treatment period, there was no significant difference in recurrent vaginal bleeding between groups [anastrozole, 4 of 83 (4.8%); tamoxifen, 9 of 88 (10.2%); P = 0.18]. Six months after randomization, the mean endometrial thickness for patients who switched to anastrozole was significantly reduced compared with those who continued tamoxifen treatment (P < 0.0001). Significantly fewer anastrozole patients required a repeat hysteroscopy and D&C compared with those on tamoxifen [4 of 83 (4.8%) and 29 of 88 (33.0%), respectively; P < 0.0001]. Repeat hysteroscopy and D&C revealed endometrial atrophy in all 4 cases in the anastrozole group and 14 polyps, 8 hyperplasias, and 7 atrophies in the tamoxifen group. Conclusions: Switching from tamoxifen to anastrozole treatment significantly reduced the need for a second hysteroscopy and D&C due to recurrent vaginal bleeding or thickening of the endometrium in postmenopausal breast cancer patients with tamoxifen-induced endometrial abnormalities.Breast cancer is a major cause of morbidity and mortality, with more than 1 million new cases and 410,000 deaths reported worldwide each year (1). For many years, the selective estrogen receptor modulator tamoxifen has been the standard treatment for postmenopausal women with hormone-sensitive breast cancer. Although tamoxifen is an estrogen receptor antagonist in breast tissue, it also acts as an estrogen agonist in other tissues such as the endometrium. This agonist effect in the endometrium can stimulate proliferation, which increases the risk of polyps, hyperplasia, and endometrial cancer by 2-to 4-fold compared with patients not receiving tamoxifen (2 -10). It has been reported that 10% of tamoxifen-treated patients will develop tamoxifen-induced endometrial pathology within 5 years, leading to operative intention (11).Although the American Society of Clinical Oncology Technology Assessment (12) has recently recommended that the optimal hormonal therapy for postmenopausal women with hormone-sensitive early breast cancer should now include an aromatase inhibito...

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“…124,125 More recently, the aromatase inhibitor anastrazole was described as being effective in causing regression of endometrial hyperplasia, including 2 cases of atypical hyperplasia in obese postmenopausal women. 126 As with patients with atypical hyperplasia who are poor surgical candidates, there are numerous reports of patients with well-differentiated (FIGO grade 1) endometrial cancers who have been successfully managed medically. Most published series analyzing the efficacy of oral progestin therapy in grade 1 endometrial carcinomas describe a regression rate in excess of 75%, with follow-up lasting 48 months or greater.…”

Section: Treatmentmentioning

confidence: 98%

Common Gynecologic Problems in Geriatric-aged Women

Moroney

Zahn

2007

Clinical Obstetrics &Amp; Gynecology

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Gynecologic concerns in postmenopausal women are common. Although various conditions may affect all women in this age group, the prevalence of certain disorders, and also diagnostic approaches and treatment options, may vary significantly when considering very elderly women compared with those early in the sixth decade. The focus of this chapter is to address several commonly encountered gynecologic issues in postmenopausal women, with particular attention given to aspects that must be considered when caring for women in the geriatric age group.

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Aromatase inhibitor anastrozole for treating endometrial hyperplasia in obese postmenopausal women

Cited by 42 publications

References 3 publications

The Effect of Letrozole and Metformin on Endometrial Histology in Patients With Disordered Proliferative Endometrium

The Effect of Letrozole and Metformin on Endometrial Histology in Patients With Disordered Proliferative Endometrium

Anastrozole versus tamoxifen treatment in postmenopausal women with endocrine-responsive breast cancer and tamoxifen-induced endometrial pathology.

Common Gynecologic Problems in Geriatric-aged Women

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