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Effect of tamoxifen on postmenopausal endometrium in breast cancer patients

Background and aims: The aim of this study was to evaluate the risk of endometrial cancer (EC) in postmenopausal breast cancer patients according to duration of tamoxifen treatment. Methods: The current study utilized tissue samples from 65 postmenopausal tamoxifen-treated breast cancer patients who underwent hysteroscopy with pathohistological evaluation in the period from 2012 to 2014. The Human Ethics Committee of the institution approved this study. The patients were divided, according to duration of tamoxifen treatment, 45 in Group I (patients treated for less than 3 years) and 20 in Group II (patients treated for longer than 3 years) and correlation with endometrial pathology was evaluated. Results: The mean age of patients was 54.5±8.8 years (range, 44 to 87 years). Vaginal bleeding was present in 18 patients (27.3%) and thickened endometrium in 47 patients (72.3%). The mean endometrial thickness was 13.23±4.68 mm (range, 6 to 36 mm). We found benign disease in 62 patients (95.4%). Non-pathologic endometrium was present in 6 patients (9.2%), endometrial polyps in 35 patients (53.8%), endometrial hyperplasia without atypia in 17 patients (26.2%) and with atypia in 4 patients (6.1%). The incidence of EC in the Group II patients was significantly higher than in the Group I (r= 0.278 ; P<0.05). We found welldifferentiated endometrioid adenocarcinomas in three patients (4.6%), all three treated with tamoxifen longer than 3 years. Conclusion: This study, in accordance with previous studies, indicates that there is an increased risk of EC associated with longer tamoxifen treatment.

Tamoxifen; Endometrium; Breast cancer patients

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