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

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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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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