Tamoksifen Kullanan Hastaların Jinekolojik Yönden Değerlendirilmesi

Year 2021, Volume: 30 Issue: 1, 45 - 51, 31.03.2021

Ümran Küçükgöz Güleç , Semra Paydaş , Ahmet Barış Güzel

https://doi.org/10.17827/aktd.899315

Abstract

Meme kanseri dünyada ve ülkemizde kadınlarda en sık görülen kanserdir. Diğer malign tümörlerde olduğu gibi meme kanserli kadınların takibi de multidisipliner yaklaşım gerektirir. Meme kanserlerinin %70 kadarı hormon duyarlıdır. Tamoksifen hormon reseptörü pozitif meme kanserli olguların hem adjuvan amaçlı hem de metastatik dönemde endokrin tedavilerinde hem pre-menopozal hem de post-menopozal dönemde etkili non-steroid selektif östrojen reseptör modülatörüdür (SERM). Dünyada en fazla kullanılan anti-kanser ilaç olan tamoksifenin diğer yan etkilerinin yanısıra önemli jinekolojik yan etkilere yol açabilir. Tamoksifen bazı benign jinekolojik patolojileri artırmakla kalmaz endometrial karsinom başta olmak üzere sarkom, karsinosarkom gibi bi-fazik malignansilerin de görülme sıklığını artırır.
Tamoksifen kullanan veya kullanmış bir kadının jinekolojik açıdan takibindeki önemli noktalar bu derlemenin amacıdır.

Keywords

Meme Kanseri, Tamoksifen, jinekolojik Değerlendirme

References

• 1. Jordan, V.C. The SERM Saga, Something from Nothing: American Cancer Society/SSO Basic Science Lecture. Ann Surg Oncol 2019; 26: 1981–90.
• 2. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet 2015 ;386 (10001): 1341-1352.
• 3. Fisher B, Costantino JP, Wickerham DL, Redmond CK, Kavanah M, Cronin WM, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 1998; 90:1371-88.
• 4. Davies C, Pan H, Godwin J, Gray R, Arriagada R, RAİnaV, et al. Long-term effects of continuing adjuvan tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomized trial. Lancet 2013;381:805-16.
• 5. Gray RG, Rea D, Handley K, Bowden SJ, Perry P, Earl HM, et al. aTTom: Long-term effects of continuing adjuvan tamoxifen to 10 years versus stopping at 5 years in6.953 women with early breast cancer. Lancet. 2013;381(9869):805-16.
• 6. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvan tamoxifen: patient-level meta-analysis of randomised trials. Lancet 2011;378:771-84.
• 7. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin 2016; 66: 43-73.
• 8. Güler N. Adjuvan Endokrin Tedavi. Meme Hastalıkları. Meme Hastalıkları Dernekleri Federasyonu: 493-507. Ankara, Güneş Tıp Kitabevi, 2012.
• 9. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn H-J Panel members. Strategies for subtypesdealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2011. Ann Oncol 2011;22:1736-47.
• 10. Cardoso F, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rubio IT, et al. ESMO Guidelines Committee. Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2019;30(8):1194-1220.
• 11. Geiser AG, Hummel CW, Draper MW, et al. A new selective estrogen receptor modulator with potent uterine antagonist activity, agonist activity in bone, and minimal ovarian stimulation. Endocrinology 2005; 146:4524-35.
• 12. Runowicz CD, Costantino JP, Wickerham DL, Cecchini RS, Cronin WM, Ford LG, et al. Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR). Am J Obstet Gynecol 2011; 205:535.e1.
• 13. Jankowitz RC, Davidson NE. Adjuvan endocrine therapy for breast cancer: How long is enough? Oncology 2013;27:1-4.
• 14. Buijs C, Willemse PH, de Vries EG, Ten Hoor KA, Boezen HM, Hollema H, et al. Effect of tamoxifen on the endometrium and the menstrual cycle of premenopausal breast cancer patients. Int J Gynecol Cancer 2009; 19:677-81.
• 15. Cheng WF, Lin HH, Torng PL, Huang SC. Comparison of endometrial changes among symptomatic tamoxifen-treated and nontreated premenopausal and postmenopausal breast cancer patients. Gynecol Oncol 1997; 66:233-7.
• 16. Hu R, Hilakivi-Clarke L, Clarke R. Molecular mechanisms of tamoxifen-associated endometrial cancer (Review). Oncol Lett 2015; 9:1495-1501.
• 17. Tsujioka H, Hachisuga T, Fukuoka M, Ueda T, Miyahara D, Horiuchi S, Shirota K, et al. Monitoring of endometrial K-ras mutation in tamoxifen-treated patients with breast cancer. Int J Gynecol Cancer 2009; 19:1052-6.
• 18. Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, McGale P, et al. Early Breast Cancer Trialists' Collaborative Group. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 2011; 378(9793): 771-84. 19. Chalas E, Costantino JP, Wickerham DL, Wolmark N, Lewis GC, Bergman C, et al. Benign gynecologic conditions among participants in the Breast Cancer Prevention Trial. Am J Obstet Gynecol. 2005;192(4):1230-7; discussion 1237-9.
• 20. Wright JD, Desai VB, Chen L, Burke WM, Tergas AI, Hou JY, et al. Utilization of gynecologic services in women with breast cancer receiving hormonal therapy. Am J Obstet Gynecol. 2017;217(1):59.e1-59.e12.
• 21. Cohen I. Endometrial pathologies associated with postmenopausal tamoxifen treatment. Gynecol Oncol. 2004;94(2):256-66.
• 22. Romero SA, Young K, Hickey M, Su HI. Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen. Cochrane Database Syst Rev. 2020 21;12:CD007245.
• 23. Committee Opinion No. 601: Tamoxifen and uterine cancer. Obstet Gynecol 2014 ; 123: 1394. Reaffirmed 2019.
• 24. Iqbal J, Ginsburg OM, Wijeratne TD, Howell A, Evans G, Sestak I, et al. Endometrial cancer and venous thromboembolism in women under age 50 who take tamoxifen for prevention of breast cancer: a systematic review. Cancer Treat Rev 2012; 38:318-328.
• 25. Markovitch O, Tepper R, Fishman A, Aviram R, Cohen I. Long-term follow-up of postmenopausal breast cancer patients following discontinuation of tamoxifen therapy. Maturitas. 2008; 59:387-93.
• 26. Hoogendoorn WE, Hollema H, van Boven HH, Bergman E, de Leeuw-Mantel G, Platteel I, et al. Prognosis of uterine corpus cancer after tamoxifen treatment for breast cancer. Breast Cancer Res Treat. 2008; 112:99-108.
• 27. Lavie O, Barnett-Griness O, Narod SA, Rennert G. The risk of developing uterine sarcoma after tamoxifen use. Int J Gynecol Cancer. 2008; 18:352-6.
• 28.Yildirim Y, Inal MM, Sanci M, Yildirim YK, Mit T, Polat M, et al. Development of uterine sarcoma after tamoxifen treatment for breast cancer: report of four cases. Int J Gynecol Cancer. 2005; 15: 1239-42.
• 29. Arici DS, Aker H, Yildiz E, Tasyurt A. Mullerian adenosarcoma of the uterus associated with tamoxifen therapy. Arch Gynecol Obstet. 2000; 264:105-7.
• 30. Engin H. High-grade endometrial stromal sarcoma following tamoxifen treatment. Gynecol Oncol. 2008; 108:253-4.
• 31. Terek MC, Akman L, Dikmen Y. Meme Kanseri Olgularına Jinekolojik Yaklaşım. Türk Jinekolojik Onkoloji Dergisi. 2004; 7/1: 1-10.
• 32. Ajit D, Gavas S, Jagtap S, Chinoy RF. Cytodiagnostic problems in cervicovaginal smears from symptomatic breast cancer patients on tamoxifen therapy. Acta Cytol. 2009;53(4):383-8.
• 33. ACOG Committee Opinion No. 734: The Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Women With Postmenopausal Bleeding. Obstet Gynecol 2018; 131:e124.
• 34. Gerber B, Krause A, Müller H, Reimer T, Külz T, Makovitzky J, et al. Effects of adjuvant tamoxifen on the endometrium in postmenopausal women with breast cancer: a prospective long-term study using transvaginal ultrasound. J Clin Oncol. 2000;18(20):3464-70.
• 35. Develioğlu OH, Omak M, Bilgin T, Esmer A, Tüfekçi M. The endometrium in asymptomatic breast cancer patients on tamoxifen: value of transvaginal ultrasonography with saline infusion and Doppler flow. Gynecol Oncol. 2004;93(2):328-35.
• 36. Fung MF, Reid A, Faught W, Le T, Chenier C, Verma S, et al. Prospective longitudinal study of ultrasound screening for endometrial abnormalities in women with breast cancer receiving tamoxifen. Gynecol Oncol 2003; 91:154-9.