Baseline hysteroscopic assessment of endometrium in asymptomatic postmenopausal women with estrogen receptor–positive breast cancer

López, Daniel María Lubián; Fernández, Yurena González; Sánchez, Ángel Vilar; Álvarez, María Iglesias; Reynaldo, María Isabel López; Delgado, Rafael Comino

doi:10.1097/gme.0b013e318259eaf3

Cited by 4 publications

(3 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study, the baseline hysteroscopic assessment revealed an incidence of 31.3% of overall endometrial morbidity in asymptomatic postmenopausal ERα+ breast cancer patients (9). For patients who have endometrial conditions such as hyperplasia without atypia prior to tamoxifen treatment, the rate of progression to more advanced stage endometrial lesions is almost 50% after 24 months of tamoxifen administration (10).…”

Section: Introductionmentioning

confidence: 99%

Molecular mechanisms of tamoxifen-associated endometrial cancer (Review)

2015

View full text Add to dashboard Cite

Tamoxifen has been prescribed to millions of females for breast cancer prevention or treatment. However, tamoxifen is known to significantly enhance the risk of developing endometrial lesions, including hyperplasia, polyps, carcinomas, and sarcoma. Notably, tamoxifen-associated endometrial cancer often has a poor clinical outcome. Understanding the molecular mechanism of tamoxifen-induced endometrial cancer is essential for developing strategies that minimize tamoxifen’s effects on the endometrium without jeopardizing its breast cancer treatment effects. However, this understanding remains limited. Tamoxifen appears to mediate its effect on endometrial cells through estrogenic and non-genomic pathways, rather than introducing a genomic alteration as a carcinogen. Although tamoxifen functions as an agonist and promotes cell proliferation in endometrial cancer, it also displays antagonist activity towards some estrogen targets. Alterations in estrogen receptor-α and its isoforms, as well as the membrane associated estrogen receptor G protein-coupled receptor 30, have been observed with tamoxifen-exposed endometrial cells, and likely mediate the effects of tamoxifen on endometrial cancer cell proliferation and invasion. In addition, gene profile studies of short-term exposure to tamoxifen indicate that the majority of tamoxifen targets are tamoxifen-specific. However, the tamoxifen regulated gene targets that are involved in mediating the effects of long-term exposure to tamoxifen are not yet fully understood. Recent progress has indicated a potential role of unfolded protein response and mammalian target of rapamycin signaling in tamoxifen-associated endometrial cancer. In the future, studies focusing on long-term effects of tamoxifen exposure are required to understand the molecular mechanisms of tamoxifen-associated endometrial cancer.

show abstract

Section: Introductionmentioning

confidence: 99%

Molecular mechanisms of tamoxifen-associated endometrial cancer (Review)

2015

View full text Add to dashboard Cite

show abstract

“…It is important to spread among oncologists and gynecologists the value of hysteroscopy, as the main obstacle that we encounter is the lack of information for patients about this possibility and referring patients for routine blind curettage. Therefore, patients are not informed about the significant value of hysteroscopy over TVS or curettage in tamoxifen-treated patients [1–5]. …”

Section: Discussionmentioning

confidence: 99%

“…These patients are carefully followed during tamoxifen treatment by their oncologists, but they rarely have their baseline endometrial assessment performed by their gynecologist. A recent Spanish study proved the value of hysteroscopic assessment prior to treatment even in asymptomatic postmenopausal women with ER-positive receptors [1]. These findings are crucially important in the case of obese, older women whose risk of endometrial pathology is primarily greater than the population risk.…”

Section: Introductionmentioning

confidence: 99%

The value of hysteroscopic-based decision-making in uterine abnormalities during tamoxifen intake in breast cancer patients - preliminary report.

Gabriel¹,

Olejek²

2014

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

Women using hormonal therapy for breast cancer are often encountered in clinical practice of breast surgeons, oncologists and gynecologists. Some of them during the course of therapy develop abnormal uterine bleeding or have ultrasound abnormalities detected. In Poland, most of them are still diagnosed using blind curettage, which does not bring a definitive diagnosis or requires repeating the diagnostic procedure. This produces unnecessary fear of malignancy in patients and increases economic costs (double curettage, unnecessary hysterectomy and its social consequences). Therefore, we studied the usefulness of hysteroscopy with targeted biopsies for further management of women treated with tamoxifen. Our goal is to provide evidence that women before entering, during and after tamoxifen treatment have hysteroscopy for endometrial assessment.

show abstract