Four case reports presenting new acquisitions on the association between breast and endometrial carcinoma

Atlante, G; M, Pozzi; Vincenzoni, Cristina; Vocaturo, Giuseppe

doi:10.1016/0090-8258(90)90371-q

Cited by 41 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of previous studies have demonstrated a link between hormonal treatment for invasive breast cancer and the development of uterine or endometrial cancer (Khandekar et al, 1978;Hardell, 1988;Fornander et al, 1989;Atlante et al, 1990;Gusberg, 1990;Mathew et al, 1990;Andersson et al, 1991;Fisher et al, 1994;Rubino et al, 2003). However, it is generally accepted that for women with invasive breast cancer, the benefits of hormonal treatment, such as tamoxifen, outweigh the associated risks (Gail et al, 1999).…”

Section: Discussionmentioning

confidence: 98%

The occurrence of invasive cancers following a diagnosis of breast carcinoma in situ

2008

View full text Add to dashboard Cite

Approximately 1 in every 600 women attending breast-screening programmes in the United Kingdom is diagnosed with breast carcinoma in situ (BCIS). However, there is little information on the occurrence of subsequent cancers (other than second breast cancers) in these women. We investigated the occurrence of invasive cancers in 12 836 women diagnosed with BCIS in southeast England between 1971 and 2003, using data from the Thames Cancer Registry. A greater than expected number of subsequent cancers was found for two sites: breast (standardised incidence ratio (SIR) 1.96; 95% confidence interval (CI) 1.79 -2.14) and corpus uteri (SIR 1.42; 95% CI 1.11 -1.78). For subsequent ipsilateral breast cancer in those treated with breast conservation, the excess was independent of the time since diagnosis of BCIS, whereas for subsequent contralateral breast cancer, there was a steady decline in excess over time. For subsequent uterine cancer, the excess became statistically significant only at 45 years after BCIS diagnosis, consistent with a treatment effect. This was further supported by Cox regression anaysis: the risk of subsequent uterine cancer was significantly increased in women receiving hormonal therapy compared with those not receiving it, with a hazard ratio of 2.97 (95% CI 1.84 -4.80). (2008) Currently, approximately 1 in every 600 women attending breastscreening programmes in the United Kingdom is diagnosed with breast carcinoma in situ (BCIS). This amounted to almost 3000 cases in 2004 (NHS Cancer Screening Programmes, 2006. The most common form of treatment is lumpectomy, with or without radiotherapy, although women with a more diffuse pattern of BCIS may undergo mastectomy. A number of previous studies have focused on the risk of second breast cancer following a diagnosis of BCIS (Habel et al, 1997;Wärnberg et al, 2000;Claus et al, 2003;Levi et al, 2005;Rawal et al, 2005), with estimates of relative risk generally of the order of two-to fivefold. Few studies have looked at the occurrence of subsequent invasive cancers at other sites (Ward et al, 1992;Franceschi et al, 1998;Soerjomataram et al, 2006), and these were based on relatively small numbers of cases. British Journal of CancerIn the current population-based study, we have investigated the occurrence of subsequent invasive cancers in a very large series of unselected women with BCIS in southeast England. We have also examined the relationship between treatment for BCIS and the development of subsequent cancers. MATERIALS AND METHODSAll recorded cases of BCIS (ICD10 code D05) diagnosed in women between 1971 and 2003 were extracted from the Thames Cancer Registry (TCR) database. The TCR is a population-based registry covering London and a large part of southeast England. Patients with any other cancers diagnosed prior to, or at the same time as, BCIS were excluded in order to avoid confounding the sequelae of BCIS with those of other cancers, particularly breast cancer. The occurrence of subsequent cancers was analysed by calculating the standardised inc...

show abstract

Section: Discussionmentioning

confidence: 98%

The occurrence of invasive cancers following a diagnosis of breast carcinoma in situ

2008

View full text Add to dashboard Cite

show abstract

“…In 1985, the first report of its association with endometrial neoplasia appeared 1. Numerous letters and case reports followed 2‐5. The first data obtained from a prospective study, carried out without a baseline endometrial assessment, reflected a 7.5‐fold increase in risk of endometrial carcinoma (average annual hazard rate of 0.2/1000 for placebo vs. 1.6/1000 for tamoxifen) 6.…”

Section: Tamoxifenmentioning

confidence: 99%

“…1 Numerous letters and case reports followed. [2][3][4][5] The first data obtained from a prospective study, carried out without a baseline endometrial assessment, reflected a 7.5-fold increase in risk of endometrial carcinoma (average annual hazard rate of 0.2/1000 for placebo vs. 1.6/1000 for tamoxifen). 6 The first prospective study that included a baseline uterine evaluation showed that, among women treated with tamoxifen, there was a 6% incidence of carcinoma, a 25% incidence of polyp formation, and a 44% incidence of proliferation.…”

Section: Tamoxifenmentioning

confidence: 99%

The Effect of SERMs on the Endometrium

Goldstein

2001

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

Tamoxifen, the first clinically available SERM, was developed in 1966 and approved by the FDA (United States Food and Drug Administration) in 1978. It is the most prescribed antineoplastic drug in the world, with approximately 10 million women‐use‐years of experience. Tamoxifen has proved efficacious in all settings of breast cancer. However, in the mid‐to‐late 1980s, a series of letters to the editor and case reports announced an association between tamoxifen therapy in women with breast cancer and the development of endometrial carcinoma. Subsequently, in 1998, the observation of a significant 49% reduction in invasive breast cancer relative to placebo in a cohort of women at increased risk for the disease resulted in the early stopping of the National Surgical Adjuvant Breast and Bowel Project's (NSABP) P‐1: Breast Cancer Prevention Trial (BCPT). Importantly, this was the first time that information became available about the effects of tamoxifen in healthy women, that is, women who did not already have breast cancer. In this healthy population, the relative risk of developing endometrial carcinoma in the tamoxifen arm was 2.54, although when stratified by age, in women over 50, the risk grew to 4.01. Thus, the risk appears to be confined to women over 50 because, in contrast, in women under 50 there was no statistically significant increase in the risk of endometrial carcinoma.

show abstract

“…which is twice the dose normally prescribed in the United States. There are other reports of endometrial carcinoma with high dose tamoxifen treatment (Hardell, 1988;Atlante et al, 1990;Magriples et al, 1993) but interest is currently focused on the epidemiology of endometrial cancer at the standard dose regimen of 20 mg daily. In a study conducted by the Southwest Oncology Group, four of the 641 patients treated for one year with tamoxifen developed endometrial cancer, compared to no cases of endometrial cancer in the 325 patients treated with adjuvant chemotherapy (Sunderland & Osborne, 1991).…”

Section: Additional Benefits Of Tamoxifen Therapymentioning

confidence: 99%