Endometrial Pathologies in Women Using Tamoxifen Due to Breast Cancer

Yıl 2008, Cilt: 2 Sayı: 3, 363 - 371, 20.11.2008

Işık Üstüner

Öz

Tamoxifen is a selective estrogen receptor modulator drug used in early and metastatic breast cancer patients. The aim of this study is to examine endometrial pathologies in those who use tamoxifen because of the breast cancer. Seventyone cases on tamoxifen who was followed-up due to breast cancer were assessed retrospectively. In accordance with the follow-up protocol, endometrial biopsy and histopathological examinations were performed. The mean age of the cases was 51.0 ± 12.7 years. The mean time duration after the diagnosis of breast cancer was 2.3 ±1.5 years; tamoxifen usage time was 1.5 ±1.1 years in average. Endometrial biopsy was performed in 27 of the 71 (38.0%) cases. 12 of those cases were premenopausal and the remaining 15 were postmenopausal. Insufficient sampling was reported in 19 of the 27 (70.4%) cases. Hysteroscopic biopsy or hysterectomy was made in 7 of the 19 undiagnosed cases due to the insufficient sampling. The results of the 7 cases were: 5 endometrial polyps and/or simple endometrial hyperplasia, 1 endometrial proliferation, and 1 case without any endometrial pathology. When obtaining endometrial biopsies in patients who use Tamoxifen, curettage procedure should be done more aggressively or further examinations and assessments should be instituted to make a definitive pathologic diagnosis and avoid not being able to diagnose histopathologically.

Anahtar Kelimeler

Tamoxifen, endometrial pathology, breast cancer

Meme Kanseri Nedeniyle Tamoksifen Kullanan Kadınlarda Endometrial Patolojiler

Öz

Tamoksifen, erken ve metastatik meme kanseri hastalarında yaygın olarak kullanılan selektif östrojen reseptör modülatörü bir ilaçtır. Bu çalışmanın amacı meme kanseri nedeniyle tamoksifen kullananlarda endometrial patolojileri incelemektir. Meme kanseri nedeniyle takip edilen ve tamoksifen kullanan 71 olgu retrospektif olarak değerlendirildi. Olgularda; takip protokolüne göre endometrial biyopsi ve histopatolojik inceleme yapıldı. Olguların yaşları ortalama 51.0 ± 12.7 yıldı. Meme kanseri tanısı aldıktan sonra geçen süre ortalama 2.3 ±1.5 yıl, Tmx kullanım süresi ortalama 1.5 ± 1.1 yıl idi. 71 olgunun 27’sine (%38.0) endometrial biyopsi uygulandı. Bu olguların 12’si premenopozal, 15’i postmenopozal idi. 27 olgunun 19’unda (%70.4) yetersiz materyal rapor edildi. Negatif endometrial küretaj nedeniyle tanı koydurucu sonuç elde edilemeyen 19 olgudan 7 olguya histeroskopi eşliğinde biyopsi veya histerektomi uygulandı. 7 olgunun patoloji sonuçlarında, 5’in-de endometrial polip ve/veya basit atipisiz endometrial hiperplazi, 1 olguda proliferatif endometrium saptanırken 1 olguda endometrial patoloji saptanmadı. Tamoksifen kullanan olgularda probe küretaj ile alınan endometrial biyopsilerde histopatolojik tanı konamaması karşısında patolojiden emin olunabilmesi amacıyla küretaj işlemi daha agresif yapılmalı veya daha ileri tetkik ve değerlendirme yapılmalıdır.

Dr. H. Levent KESKİN, Dr. Nilüfer AKGÜN Dr. Tuba SEMERCİ, Dr. Işık ÜSTÜNER, Dr. Emine ÇELEN, Dr. Serpil AYDOĞMUŞ, Dr. Ayşegül ÇİNKAYA, Dr. Mustafa UZUN, Dr. Mehmet GÜMÜŞ, Dr. A. Filiz AVŞAR

Anahtar Kelimeler

Tamoksifen, endometrial patoloji, meme kanseri

Kaynakça

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