The evaluation of laparotomy results in breast cancer patients with gynecological pathologies

Abstract

Aim: The aim of the study was to evaluate the results of the laparotomies due to gynecological pathologies in breast cancer patients and to assess the distribution of gynecological pathologies and the clinical and laboratory findings contributing to the diagnosis. Methods: This study was conducted between years 2002 and 2011 at Hacettepe University Hospital. We obtained information about 86 consecutive breast cancer patients, including age, time of diagnosis and pathology of breast cancer, hormone receptor status, history of endocrine therapy, presenting symptoms, ultrasonography findings, CA 125 levels, endometrial biopsy results, type of gynecological surgery and pathology results. Data were analyzed with the use of SPSS software. Results: Twenty-one (24.4%) out of 86 patients had endometrial pathology, and 24 (27.9%) had adnexal pathology. Fourteen patients (16.2%) had malignant pathology, and of them, 11 had ovarian cancer 3 had endometrial cancer. There were five abnormal cytological findings: 2 ASCUS, 1 LSIL, 1 ASC-H and 1 adenocarcinoma. The patient with the cytology report of adenocarcinoma had the final diagnosis of endometrial cancer. Of the patients, 67 (77.9%) used tamoxifen, whereas 19 (22.1%) did not. Thirty-three patients (38.4%) with gynecological pathologies were detected incidentally during routine follow-up of breast cancer. Conclusion: This study supports the increase of the gynecological pathology incidence in breast cancer patients and the recommendation of close gynecological follow-up in these patients. Asymptomatic patients might also develop genital cancer. The ultrasonographic appearance of the adnexal masses or endometrial thickness and any abnormal vaginal bleeding or high CA 125 levels are important parameters for evaluating breast cancer patients. Key words: abnormal uterine bleeding/endometrial hyperplasia, breast cancer, cancer of the endometrium, epithelial cancer of the ovary, metastatic tumors of the ovary.

Endometrial pathologies in clinical follow-up of patients with hormone receptor-positive/negative breast cancer

“…Following this, cases featuring AUB were recorded in 28 instances (16.9%). In extant literature, AUB surfaces in approximately 50% of premenopausal cases and 25% of postmenopausal cases [10][11][12][13]. Notably, the preponderance of cases within our study was situated in the premenopausal period, and the routine gynecological surveillance of breast cancer patients is more frequent within our country due to medical practices.…”

“…While the prevalence of endometrial polyps within the general population fluctuates between 0-10%, patients undergoing tamoxifen treatment face an elevated risk, with incidence rates ranging from 6-42% [9][10][11][12]. Although endometrial polyps are benign, the likelihood of malignant transformation among endometrial polyps in the broader population is approximately 2% during the premenopausal phase and 5% during the postmenopausal phase.…”

Evaluation of Pathology Results of Patients with a History of Breast Cancer who were Operated on for Gynecological Pathologies or Prophylaxis

“…Tamoxifen used in breast cancer patients with its low estrogenic effect on the uterine corpus, may cause epithelial and non-epithelial uterine corpus lesions such as polyps, hyperplasia, cancer, and uterine sarcoma (8,9). Mostly seen endometrial pathology in breast cancer patients using tamoxifen has been reported as endometrial polyp, this rate is approximately 8-44% in the previous studies (8,10).…”