Robinson D C, Bloss J D, Schiano M A
Wilford Hall Medical Center, Lackland AFB, San Antonio, Texas 78236-5300, USA.
Gynecol Oncol. 1995 Nov;59(2):186-90. doi: 10.1006/gyno.1995.0005.
To assess the relationship between low-dose tamoxifen, usage and endometrial cancer in breast cancer patients.
In this case-control study, the records of the 1017 patients treated at Wilford Hall Medical Center for primary breast cancer between 1978 and 1989 were reviewed. Dose and duration of tamoxifen therapy were recorded as well as the presence of a uterus. Potential confounding variables including diabetes mellitus, hypertension, age, weight, tobacco use, and family history of breast or gynecologic cancer were recorded.
Of the 1017 patients in the study, 56 had inadequate records and 375 had undergone a prior hysterectomy and these patients were excluded from the study, leaving 586 eligible patients. Of these 586 women with primary breast cancer and no previous hysterectomy, 108 patients had received tamoxifen, 10 mg twice a day for greater than 1 year. Four of the 108 patients subsequently developed endometrial adenocarcinoma. Four hundred seventy-eight breast cancer patients did not receive tamoxifen and 4 later developed endometrial adenocarcinoma. The odds ratio for the development of endometrial cancer when exposed to tamoxifen was 15.2 with a 95% confidence interval of 2.8-84.4. The patients exposed and not exposed to tamoxifen were compared for potential confounding variables and after controlling for the potential confounders, tamoxifen was found to be an independent risk factor for the development of endometrial cancer.
Low-dose tamoxifen when given for greater than 1 year is associated with secondary endometrial cancer in patients with primary breast cancer.
评估低剂量他莫昔芬的使用与乳腺癌患者子宫内膜癌之间的关系。
在这项病例对照研究中，回顾了1978年至1989年间在威尔福德·霍尔医疗中心接受原发性乳腺癌治疗的1017例患者的记录。记录了他莫昔芬治疗的剂量和持续时间以及子宫的存在情况。记录了潜在的混杂变量，包括糖尿病、高血压、年龄、体重、吸烟情况以及乳腺癌或妇科癌症家族史。
在研究的1017例患者中，56例记录不完整，375例曾接受过子宫切除术，这些患者被排除在研究之外，剩下586例符合条件的患者。在这586例原发性乳腺癌且未行子宫切除术的女性中，108例患者接受了他莫昔芬治疗，每天两次，每次10毫克，持续超过1年。108例患者中有4例随后发生了子宫内膜腺癌。478例乳腺癌患者未接受他莫昔芬治疗，其中4例后来发生了子宫内膜腺癌。暴露于他莫昔芬时发生子宫内膜癌的比值比为15.2，95%置信区间为2.8 - 84.4。对暴露和未暴露于他莫昔芬的患者的潜在混杂变量进行了比较，在控制了潜在混杂因素后，发现他莫昔芬是子宫内膜癌发生的独立危险因素。
原发性乳腺癌患者使用低剂量他莫昔芬超过1年与继发性子宫内膜癌有关。
