You are here

Article Text

Article menu
Download PDFPDF
Original Articles: Endometrial Cancer
Effect of Tamoxifen on the Endometrium and the Menstrual Cycle of Premenopausal Breast Cancer Patients
  1. Ciska Buijs, MD, PhD*,
  2. Pax H. B. Willemse, MD, PhD*,
  3. E. G. E. De Vries, MD, PhD*,
  4. Klase A. Ten Hoor, PhD*,
  5. H. M. Boezen, PhD†,
  6. Harry Hollema, MD, PhD‡ and
  7. Marian J. E. Mourits, MD, PhD§
  1. *Departments of Medical Oncology,
  2. †Departments of Epidemiology,
  3. ‡Departments of Pathology, and
  4. §Departments of Gynecological Oncology, University Medical Center Groningen, University of Groningen, the Netherlands.
  1. Address correspondence and reprint requests to Marian J. E. Mourits, MD, PhD, Department of Gynecological Oncology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, the Netherlands. E-mail: m.j.e.mourits{at}og.umcg.nl.

Abstract

Objective: Tamoxifen, a nonsteroidal antiestrogen, is the agent of choice in the treatment of premenopausal receptor-positive breast cancer. This study aimed to investigate the influence of tamoxifen on the menstrual cycle and serum hormone levels and the subsequent endometrial response in premenopausal breast cancer patients.

Methods: In tamoxifen-using breast cancer patients aged 55 years or younger, the last menstrual period was registered, serum hormone levels measured, and the endometrial response visualized by transvaginal ultrasonography every 6 months. Premenopausal status was defined as serum levels of estradiol (E2) 0.10 nmol/L or more and follicle-stimulating hormone 30 IU/L or less. Premenopausal patients with an endometrial response of greater than 12 mm were offered a hysteroscopy and curettage.

Results: In 121 patients, a total of 241 measurements were performed. Amenorrhea predicted menopausal status incorrectly in 85 (35%) of the 241 measurements in 47 patients. In 8 of 47 endocrinologic premenopausal patients, transvaginal ultrasonography showed an endometrial response of greater than 12 mm (range,15-29 mm). Histopathology in women with an endometrial thickness of greater than 12 mm showed no malignancy. No relation between E2 levels and endometrial thickness was found.

Conclusions: Tamoxifen leads to a disconnection between clinical and endocrinologic menopause in breast cancer patients aged 55 years or less. In premenopausal patients, tamoxifen has a predominantly antiestrogenic effect on the endometrium without a correlation between E2 levels and endometrial response.

  • Amenorrhea
  • Breast cancer
  • Endometrium
  • Estradiol and FSH
  • Menstrual cycle
  • Premenopause
  • Tamoxifen

https://doi.org/10.1111/IGC.0b013e3181a47cbe

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.