Gynecologic Clinicopathological Evaluation of Women with Breast Cancer Using Tamoxifen

INTRODUCTION: Tamoxifen is a selective estrogen modulator agent used in breast cancer women. While it has an antiestrogenic effect in the breast, it has estrogenic and antiestrogenic effects in the genital system. It has side effects such as endometrial polyps, hyperplasia, cancer, and ovarian cysts in the uterus and ovaries. In our study, we examined the gynecological clinical and pathological features of patients using tamoxifen.
METHODS: In this retrospective study, 183 women’s, using tamoxifen for breast cancer, demographic data, comorbidities, menopausal status, admission symptoms, ultrasound findings, endometrial sampling results, tamoxifen duration of use were obtained from patient files and evaluated.
RESULTS: The mean age of 183 patients included in our study was 53.86±10.04. Ovarian cysts were detected in 22 (12%) patients, 15.6% of premenopausal and 8.6% of postmenopausal patients. 13.7% of all patients, 17.8% of premenopausal, and 9.7% of postmenopausal patients had abnormal uterine bleeding. Endometrial sampling was performed in 54.1% of the patients. Endometrial biopsy results were unsatisfactory in 18.6% of the patients, benign findings in 15.3%, atrophy in 6.6%, polyps in 9.3%, hyperplasia without atypia in 2.2%, hyperplasia with atypia in 1.1%, and cancer in 1.1%. Abnormal uterine bleeding rates were statistically higher in those who received treatment at 60 months or more than under 60 months.
DISCUSSION AND CONCLUSION: Tamoxifen is associated with pathologies such as polyps, hyperplasia, cancer, and ovarian cyst. Uterine pathologies usually present with abnormal uterine bleeding. As the duration of tamoxifen use increases, the rate of abnormal uterine bleeding also increases.

Tamoksifen Kullanan Meme Kanserli Kadýnlarýn Jinekolojik Açýdan Klinikopatolojik Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Tamoksifen, meme kanserli kadýnlarda kullanýlan bir selektif östrojen modülatör ajandýr. Memede antiöstrojenik etkiye sahipken, genital sistemde östrojenik ve antiöstrojenik etkileri vardýr. Uterus ve overlerde; endometrial polip, hiperplazi, kanser, over kistleri gibi yan etkileri vardýr. Çalýþmamýzda tamoksifen kullanan hastalarýn jinekolojik açýdan klinik ve patolojik özelliklerini inceledik.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmada, meme kanseri için tamoksifen kullanan 183 kadýnýn demografik verileri, komorbiditeleri, menopoz durumu, baþvuru semptomlarý, ultrason bulgularý, endometriyal örnekleme sonuçlarý, tamoksifen kullaným süreleri hasta dosyalarýndan elde edilerek deðerlendirildi.
BULGULAR: Çalýþmamýza dâhil edilen 183 hastanýn yaþ ortalamasý 53,86±10,04 idi. Toplam 22 (%12) hastada over kisti saptandý. Premenopozal hastalarýn %15,6'sýnda ve postmenopozal hastalarýn %8,6'sýnda kist tespit edildi. Tüm hastalarýn %13,7'sinde, premenopozal hastalarýn %17,8'inde ve postmenopozal hastalarýn %9,7'sinde anormal uterin kanama görüldü. Hastalarýn %54,1'inde endometriyal örnekleme yapýldý. Hastalarýn %18,6'sýnda endometriyal biyopsi sonuçlarý yetersiz, %15,3'ünde benign bulgular, %6,6'sýnda atrofi, %9,3'ünde polip, %2,2'sinde atipisiz hiperplazi, %1,1'inde atipili hiperplazi ve %1,1'inde kanser saptandý. Anormal uterin kanama oranlarý, 60 ay veya üzerinde tedavi görenlerde, 60 ayýn altýnda tedavi görenlere göre istatistiksel olarak daha yüksekti.
TARTIÞMA ve SONUÇ: Tamoksifen, polip, hiperplazi, kanser ve over kisti gibi patolojilerle iliþkilidir. Uterus patolojileri genellikle anormal uterin kanama ile kendini gösterir. Tamoksifen kullaným süresi arttýkça anormal uterin kanama oraný da artmaktadýr.