I was on tamoxifen for 9 months Sep03 to Jun04 to help reduce my chance of recurrence. With my family doctor and my oncologist's approval, I went off tamoxifen in June 04 because of the awful side effects it was causing. My monthly cycle has been awful for the past few months with painful cramps, pelvic pain and almost daily,irregular bleeding.
It has definitely been an unwelcome guest in my life and has been causing havoc for me in the bedroom thank god for a very understanding and supportive boyfriend. My GP got me a quick referral to a gynecologist this week. Unfortunately, I was not impressed with his non-chalant approach to my concerns.
The risk decreases from the active to follow-up phase of treatment 8. In addition, although levonorgestrel intrauterine system LNG-IUS has been used in patients with breast patients taking tamoxifen TAM to prevent endometrial proliferation, the benefits, the side effects, and the patients suitable for this treatment are still elusive 9. The above facts clearly indicate the needs for further clarification of the potential link between Tamoxifen use and the risk for endometrial cancer.
Since the incidences of breast and endometrial cancer have been increasing Figure 1 , according to the Taiwan cancer registration system https: Materials and Methods A retrospective cohort study was conducted to evaluate tamoxifen use on endometrial cancer risk for breast cancer patients in Taiwan. In our study, the data included details of inpatient orders files, inpatient expenditures by admissions files, details of ambulatory care orders files and ambulatory care expenditures files.
All identifiers of all patients were completely removed before the release of the documentation and the encrypted data used in our study cannot link to any of the specific individual. A total of 74, patients treated for breast cancer between January 1, and December 31, were included in the study. The cases were identified according to the coding of Ninth Revision International Classification of Diseases ICD-9 malignant neoplasm of female breast.
Of the 74, patients, 39, The duration of tamoxifen treatment was timed from the first to the last prescription for tamoxifen. Premenopausal women treated with tamoxifen have no known increased risk of uterine cancer and as such require no additional monitoring beyond routine gynecologic care. Unless the patient has been identified to be at high risk of endometrial cancer, routine endometrial surveillance has not proved to be effective in increasing the early detection of endometrial cancer in women using tamoxifen.
Such surveillance may lead to more invasive and costly diagnostic procedures and, therefore, is not recommended. Emerging evidence suggests the presence of high-risk and low-risk groups for development of atypical hyperplasias with tamoxifen treatment in postmenopausal women based on the presence or absence of benign endometrial polyps before therapy. Thus, there may be a role for pretreatment screening of postmenopausal women with transvaginal ultrasonography, and sonohysterography when needed, or office hysteroscopy before initiation of tamoxifen therapy.
If continued use of tamoxifen therapy is advised and the risks are accepted by the patient, hysterectomy should be considered in women with atypical endometrial hyperplasia. Tamoxifen and endometrial cancer.
Ann N Y Acad Sci ; Gynaecological monitoring during tamoxifen therapy. Endometrial cancer in tamoxifen-treated breast cancer patients: J Natl Cancer Inst ; Tamoxifen use in breast cancer patients who subsequently develop corpus cancer is not associated with a higher incidence of adverse histologic features.
High-grade endometrial carcinoma in tamoxifen-treated breast cancer patients. J Clin Oncol ; Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Association of tamoxifen and uterine sarcoma. Surveillance, epidemiology, and end results analysis of cases of uterine sarcoma — Tamoxifen in advanced breast cancer. Cancer Treat Rev ;5: Tamoxifen for prevention of breast cancer: Comparison of endometrial changes among symptomatic tamoxifen-treated and nontreated premenopausal and postmenopausal breast cancer patients.
Changes mimicking endometrial neoplasia in postmenopausal, tamoxifen-treated women with breast cancer: Ultrasound Obstet Gynecol ;6: Tamoxifen and the endometrium: Breast Cancer Res Treat ; Prospective longitudinal study of ultrasound screening for endometrial abnormalities in women with breast cancer receiving tamoxifen. Investigation of endometrial abnormalities in asymptomatic women treated with tamoxifen and an evaluation of the role of endometrial screening.
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© Copyright 2017 Tamoxifen treatment for endometrial cancer. Treatment of stage III endometrial cancer, stage IV endometrial cancer, and recurrent endometrial cancer may include the following: Surgery (radical hysterectomy and removal of lymph nodes in the pelvis so they can be viewed under a microscope to check for cancer cells) followed by adjuvant chemotherapy and/or radiation therapy..