https://researchopenworld.com/tamoxifen-uterine-corpus-cancer-and-breast-cancer/#

Abstract

Background: In 2017 we described 5-year histological and disease-free survival data from a series of 429 patients with cancers of the uterine corpus (UCC), observing similar percentages to those described in the medical literature. The only difference we found with other published studies was a slightly lower percentage of serous carcinomas (SC) in the Western countries, but similar to the 3% of all SC in Japan [1]. The objective of this study was to evaluate the prognosis of uterine corpus cancer and the influence of tamoxifen on the histological types of uterine body cancer, and their long-term survival (20 year follow-up). Methods: Two series of patients were included in this study: [1] 429 patients with uterine corpus cancer and [2] 1385 patients with breast cancer. The second group included 1057 patients who had been treated with tamoxifen and 328 who had not been treated. All women had been diagnosed at the same Hospital (General University Hospital of Vigo). Crossing both series, we observed that 51 women were diagnosed with both uterine and breast neoplasias. Previously, we had excluded those cases of breast cancer (n = 1051) at the time of closing the data collection as we were not certain whether or not they had received hormonal treatment. We compared histological types of corpus uterine cancer for women with and without a prior diagnosis of breast cancer. Age of diagnosis, uterine tumor stage, histological cell type, histological grade, treatment and time 20 year free disease were analyzed using Kaplan-Meier and log-rank test analysis. Results: Women diagnosed with UCC with a personal history of a previous breast cancer treated with tamoxifen had UCC with significantly more undifferentiated histological types than those with UCC who had not received tamoxifen: with a significantly higher proportion of uterine papillary serous carcinomas (3.2 % vs. 1.9 %), clear cell (6.4 % vs. 3.7 %), indifference carcinoma (3.2% vs. 0.8%) and sarcomas (9.7% vs. 3,7%) compared to those without a personal history of breast cancer (p < 0.001). There were no differences with regards FIGO Stage uterine corpus cancer with and without breast cancer history (p > 0.05). The 20-years free of disease survival in patients with endometrial adenocarcinoma was significantly decreased in women with tamoxifen breast cancer history (p = 0.04). Conclusions: In this study, our data showed that women with uterine corpus cancer who had a personal history of breast cancer treated with tamoxifen had an increased risk of developing more aggressive UCCs and a lower 20-years free of disease survival. The odds ratio was 2.4. We think that a regular uterine endometrial and myometrial follow-up in the very long term is necessary in women diagnosed with breast cancer and treated with tamoxifen.