Endometrial Changes with Tamoxifen: Comparison between Tamoxifen-Treated and Nontreated Asymptomatic, Postmenopausal Breast Cancer Patients

Cohen, Ilan; Rosen, Doron J.D.; Shapira, Jermia; Cordoba, Mario; Gilboa, Shlomo; Altaras, Marco M.; Dror, Yigal; Beyth, Yoram

doi:10.1006/gyno.1994.1029

Cited by 107 publications

(48 citation statements)

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“…The frequency of the different endometrial histological findings as well as of overall positive endometrial histological findings diagnosed following hysteroscopy in the present study are similar to those previously described by us [4,6,7,10,12] as well as by others [2,3,5,9,13]. It is important to emphasize that the two operative procedures were not performed on the same patients.…”

Section: Resultssupporting

confidence: 77%

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Postmenopausal Endometrial Pathologies with Tamoxifen Treatment: Comparison between Hysteroscopic and Hysterectomy Findings

Cohen¹,

Azaria²,

Aviram³

et al. 1999

Gynecol Obstet Invest

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Histological findings of endometrial specimens collected by hysteroscopy from 261 postmenopausal breast cancer patients with tamoxifen treatment (group I) and from endometrial specimens obtained following hysterectomy from 40 similar patients (group II) were compared. This comparison was performed in order to assess whether endometrial pathologies are more frequently diagnosed in specimens collected by hysterectomy than by those collected during hysteroscopy in such patients. Overall positive endometrial histological findings were significantly more common in group II patients than in group I patients (82.5 and 24.5%, respectively; p < 0.0001). Atrophic endometrium was significantly more common in group I patients than in group II patients (75.5 and 15.0%, respectively; p < 0.0001). All other different endometrial pathologies, except for proliferative endometrium, were significantly more common in group II patients than in group I patients (endometrial hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial polyps = 30.0 and 11.5%, respectively; p < 0.006; endometrial polyps with hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial carcinoma = 15.0 and 0.4%, respectively; p < 0.0001). These findings suggest that in postmenopausal breast cancer patients treated with tamoxifen, the frequency of various endometrial histological findings and of overall positive endometrial histological findings were significantly higher in specimens collected by hysterectomy than in specimens obtained by hysteroscopy.

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Section: Resultssupporting

confidence: 77%

“…According to our protocol, hysteroscopy was performed in each patient in whom routine TVS detected thick endometrium (1 5 mm) [4,6].…”

Section: Methodsmentioning

confidence: 99%

Postmenopausal Endometrial Pathologies with Tamoxifen Treatment: Comparison between Hysteroscopic and Hysterectomy Findings

Cohen¹,

Azaria²,

Aviram³

et al. 1999

Gynecol Obstet Invest

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“…Tamoxifen has an effect on the endometrium that varies with the serum estradiol (E2) concentration in that it will function as an estrogen agonist only in postmenopausal women. [17][18][19][20] An increased risk of endometrial carcinoma has been described, specifically in postmenopausal women, and the risk increases with cumulative dose and duration of tamoxifen treatment. 6,[21][22][23][24][25] Cheng et al compared the endometrial findings of pre-and post-menopausal women receiving tamoxifen therapy with abnormal bleeding.…”

Section: -15mentioning

confidence: 99%

The effect of adjuvant hormonal therapy on the endometrium and ovary of breast cancer patients

2008

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Objective:To investigate the effect of adjuvant hormonal therapy on the endometrium and ovary of breast cancer patients. Methods: A retrospective review was performed on the 207 patients who had taken tamoxifen or anastrozole, as adjuvant hormonal therapy after breast cancer surgery between January 2003 and December 2006. Gynecologic surveillance constituted of ultrasonographic exam of the endometrial thickness and ovarian cyst formation. The patients were classified into three groups and analyzed; premenopausal/postmenopausal women receiving tamoxifen and women receiving anastrozole. Results: Mean duration of follow up?was 20.6±6.6 months. There was no difference of mean endometrial thickness before hormonal therapy among the three groups (p=0.327). In women receiving tamoxifen, the endometrium was continuously thickened in proportion to the duration of the therapy irrespective of menopausal status while it remained unchanged in women receiving anastrozole (p＜0.05). Endometrial biopsies were performed in 28 patients receiving tamoxifen. The most common histologic finding was proliferative endometrium in premenopausal women (7/21) and atrophic endometrium in postmenopausal women (6/7). There was no case of endometrial cancer in both groups. Ovarian cyst was found in 32 women and the most were developed in premenopausal women receiving tamoxifen (30/32). All of them showed benign nature on transvaginal ultrasonographic findings. Conclusion: Women undergoing adjuvant hormonal therapy after breast cancer surgery exhibited changes in the endometrium and ovary. However most changes were not a serious problem in this study and frequent gynecologic surveillance in these patients needs further investigation.

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“…However, in a previous study [6], we have found that TAM-treated patients tend to have more endometrial proliferative abnormalities than similar nontreated ones.…”

Section: Discussionmentioning

confidence: 96%

Different Coexisting Gynecological and Endometrial Pathologies in Postmenopausal Breast Cancer Patients Treated with Tamoxifen

Cohen¹,

Beyth²,

Bernheim³

et al. 1998

Gynecol Obstet Invest

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Tamoxifen administration to postmenopausal women has been described as being associated with various endometrial and other gynecological pathologies. However, different coexisting gynecological pathologies in such patients have not yet been described. In the present study, we assessed the histopathological conditions diagnosed in endometrium, myometrium, and ovaries of 28 postmenopausal breast cancer patients who were treated with tamoxifen (study group) and compared the findings to those obtained from 14 similar patients without tamoxifen treatment (control group I) and from 28 age-matched healthy postmenopausal controls (control group II). All specimens were removed by total abdominal hysterectomy and bilateral salpingo-oophorectomy for various indications. The overall incidence of two or more different coexisting gynecological pathologies was significantly higher among the study group (92.9%) than in control group I or in control group II (42.9 and 50%, respectively; p = 0.0001). There was no significant statistical difference between the control groups. Overall endometrial (and endometrial-like) origin of pathological conditions was significantly more common in the study group (92.6%) than in control group I (50%; p = 0.00072) and control group II (32.1%; p = 0.0000), while there was no significant difference between the latter two groups. These findings suggest that there might be an association between postmenopausal tamoxifen exposure and the development of such different coexisting or specific single gynecological pathologies originating from the endometrium.

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Endometrial Changes with Tamoxifen: Comparison between Tamoxifen-Treated and Nontreated Asymptomatic, Postmenopausal Breast Cancer Patients

Cited by 107 publications

References 0 publications

Postmenopausal Endometrial Pathologies with Tamoxifen Treatment: Comparison between Hysteroscopic and Hysterectomy Findings

Postmenopausal Endometrial Pathologies with Tamoxifen Treatment: Comparison between Hysteroscopic and Hysterectomy Findings

The effect of adjuvant hormonal therapy on the endometrium and ovary of breast cancer patients

Different Coexisting Gynecological and Endometrial Pathologies in Postmenopausal Breast Cancer Patients Treated with Tamoxifen

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