Uziely B, Lewin A, Brufman G, Dorembus D, Mor-Yosef S
Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem, Israel.
Breast Cancer Res Treat. 1993;26(1):101-5. doi: 10.1007/BF00682705.
Tamoxifen is one of the most important treatments for breast cancer, especially in postmenopausal patients. It acts primarily as an anti-estrogenic agent, due to its cytoplasmic estrogen receptor binding capacity. However, it also exerts a mild estrogenic effect. Since the prolonged use of estrogen has been reported to increase the rate of benign and malignant changes in the endometrium, we evaluated whether there is a correlation between tamoxifen therapy and endometrial benign and malignant conditions. The study group comprised 95 patients with breast cancer who were treated with tamoxifen. No control group was examined. Patients underwent vaginal ultrasonography and endometrial biopsy in order to evaluate any changes in the endometrium occurring during tamoxifen therapy. Pathological changes were observed in 14 patients, 13 of whom were treated with tamoxifen for more than 12 months. Of these women, 3 were diagnosed with endometrial cancer, 3 had mild dysplasia, 3 had endometrial hyperplasia, and 4 had a benign endometrial polyp. Our findings indicate a significant correlation between long-term tamoxifen administration and endometrial proliferation. We therefore recommend that women treated with tamoxifen for more than 12 months have an annual vaginal ultrasonography and endometrial biopsy.
他莫昔芬是乳腺癌最重要的治疗方法之一，尤其是对于绝经后患者。由于其与细胞质雌激素受体的结合能力，它主要作为一种抗雌激素药物发挥作用。然而，它也会产生轻微的雌激素效应。由于长期使用雌激素已被报道会增加子宫内膜良性和恶性病变的发生率，我们评估了他莫昔芬治疗与子宫内膜良性和恶性疾病之间是否存在相关性。研究组包括95例接受他莫昔芬治疗的乳腺癌患者。未设立对照组。患者接受阴道超声检查和子宫内膜活检，以评估他莫昔芬治疗期间子宫内膜发生的任何变化。14例患者出现病理变化，其中13例接受他莫昔芬治疗超过12个月。在这些女性中，3例被诊断为子宫内膜癌，3例有轻度发育异常，3例有子宫内膜增生，4例有良性子宫内膜息肉。我们的研究结果表明长期服用他莫昔芬与子宫内膜增生之间存在显著相关性。因此，我们建议接受他莫昔芬治疗超过12个月的女性每年进行一次阴道超声检查和子宫内膜活检。
