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A Journal on Internal Medicine

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Panminerva Medica 2000 March;42(1):45-7

language: English

Tamoxifen effects on endometrium

Colacurci N., De Seta L., De Franciscis P., Mele D., Fortunato N., Cassese S.

From the Insti­tute of Obstet­rics and Gynae­col­o­gy Sec­ond Uni­ver­sity of ­Naples ­School of Med­i­cine, ­Naples, Ita­ly


Back­ground. To eval­u­ate the ­effects on the endo­me­tri­um of a ­long ­term treat­ment ­with Tamox­i­fen in post­men­o­pau­sal ­patients, asymp­to­mat­ic for gyne­co­log­ic dis­or­ders, sur­gi­cal­ly treat­ed for ­breast can­cer.
Meth­ods. Set­ting: Out­pa­tient men­o­pau­sal clin­ic and endo­scop­ic ­unit. ­Patients and inter­ven­tions: 45 ­patients (­Group I) ­were treat­ed ­with 20 mg of Tamox­i­fen dai­ly for a ­mean of 23.4 ­months. Sev­en ­patients (­Group II) rep­re­sent­ed the con­trol ­group and did not ­receive Tamox­i­fen. A trans­vag­i­nal ultra­so­nog­ra­phy and a hys­ter­os­cop­ic guid­ed biop­sy ­were per­formed in all ­patients.
­Results. Sag­it­tal sono­grams ­showed abnor­mal endo­me­tri­al thick­en­ing (­range 8-32 mm, ­mean 13 mm) in 17 ­patients (35.4%) of ­Group I and in 1 ­patient of ­Group II. Pathol­o­gy on endo­me­tri­al tis­sue sam­pling ­obtained at the ­time of hys­ter­os­co­py ­showed hyper­plas­tic endo­me­tri­al ­polyps in 3 ­patients (6.25%), endo­me­tri­al hyper­pla­sia in 16 ­patients (33.4%), ­while 1 ­patient had an endo­me­tri­al ­polyp can­cer on a back­ground of hyper­pla­sia and 1 had a super­fi­cial endo­me­tri­al can­cer (4.1%). Out of the 7 ­patients of ­Group II, one had an endo­me­tri­al ­polyp, ­while 6 had no rel­e­vant endo­me­tri­al abnor­mal­ities.
Con­clu­sions. Our ­study con­firms ­that Tamox­i­fen treat­ment is asso­ciat­ed ­with an ­increased inci­dence of pro­life­ra­tive and neo­plas­tic endo­me­tri­al chang­es. No obvi­ous cor­re­la­tion was ­found ­between the ­length of Tamox­i­fen expo­sure ­time and occur­rence of endo­me­tri­al pathol­o­gies. It is man­da­to­ry to under­take ­twice per ­year gyne­co­log­ical eval­u­a­tions for ­patients treat­ed ­with Tamox­i­fen to prompt­ly iden­ti­fy and cor­rect­ly man­age endo­me­tri­al chang­es.

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