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Ege Journal of Medicine
2005, Cilt 44, Sayı 2, Sayfa(lar) 101-105
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Yıldız ERHAN1, Osman ZEKİOĞLU1, Mustafa COŞAN TEREK2, Levent AKMAN2, Aydın ÖZSARAN2, Yılmaz DİKMEN1, Fatih ŞENDAĞ2
1Department of Pathology Ege University Faculty of Medicine, Turkey
2Department of Obstetrics and Gynecology Ege University Faculty of Medicine, Turkey
Keywords: Tamoxifen, endometrial neoplasia, breast cancer, transvaginal sonography

The aim of the present study is to report the clinicopathologic features of endometrial cancers subsequently develepod after adjuvant treatment of breast cancer with tamoxifen. Seven endometrial cancers in tamoxifen-treated breast cancer patients were treated at our institution between 1994 and 2002. Medical reports of the patients were evaluated retrospectively. All patients were postmenopausal and one patient was nulliparous.

The age at discovery of the endometrial carcinoma ranged from 53-78. The menopausal age ranged from 40-53. Six of seven postmenopausal patients had postmenopausal uterine bleeding as the initial complaint. Only one patient was found to have endometrial cancer at annual gynecologic examination. Endometrial neoplasia was diagnosed by dilatation and curettage in all cases. The patients had been treated with 20 mg of tamoxifen daily for 1-14 years. Six patients were found to have endometrial carcinoma during adjuvant tamoxifen treatment. Only one patient developed endometrial carcinoma six years after the cessation of adjuvant tamoxifen treatment. Histopathologic examination of the specimens revelaed five cases of adenocarcinoma and two cases of sarcoma. Malignant mixed mesodermal tumor and adenosarcoma of the endometrium developed in long-term tamoxifen users (8 and 14 years, respectively).

Patients with breast cancer using adjuvant tamoxifen treatment, especially the long-term users should be monitored for the possibility of endometrial neoplasia. It is notable that five out of seven endometrial malignancies were not of endometrioid subtype.

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