Hysteroscopic Evaluation of Endometrial Changes in Breast Cancer Women with or without Hormone Therapies: Results from a Large Multicenter Cohort Study

被引:27
作者
Chiofalo, Benito [1 ]
Mazzon, Ivano [2 ]
Antonio, Silvia Di Angelo [2 ]
Amadore, Donatella [3 ]
Vizza, Enrico [1 ]
Lagana, Antonio Simone [4 ]
Vocaturo, Giuseppe [1 ]
Calagna, Gloria [5 ]
Favilli, Alessandro [6 ]
Palmara, Vittorio [3 ]
Maranto, Marianna [5 ]
Vitale, Salvatore Giovanni [7 ]
Cucinella, Gaspare [5 ]
Granese, Roberta [3 ]
Ghezzi, Fabio [4 ]
Sperduti, Isabella [8 ]
Triolo, Onofrio [3 ]
机构
[1] IRCCS Regina Elena Natl Canc Inst, Gynecol Oncol Unit, Dept Expt Clin Oncol, Rome, Italy
[2] Nuova Villa Claudia Clin, Arbor Vitae Ctr, Rome, Italy
[3] Univ Messina, Dept Human Pathol Adulthood & Childhood G Barresi, Unit Gynecol & Obstet, Messina, Italy
[4] Univ Insubria, Filippo Del Ponte Hosp, Dept Obstet & Gynecol, Piazza Biroldi 1, I-21100 Varese, Italy
[5] Univ Palermo, Villa Sofia Cervello Hosp, Gynecol & Obstet Unit, Palermo, Italy
[6] Univ Perugia, S Maria Misericordia Hosp, Dept Surg & Biomed Sci, Sect Obstet & Gynecol, Perugia, Italy
[7] Univ Catania, Dept Gen Surg & Med Surg Specialties, Catania, Italy
[8] IRCCS Regina Elena Natl Canc Inst, Biostat Unit, Rome, Italy
关键词
Tamoxifen; Aromatase inhibitors; Breast cancer; Endometrial cancer; Endometrial pathologies; TRANSVAGINAL ULTRASONOGRAPHY; POSTMENOPAUSAL PATIENTS; TAMOXIFEN TREATMENT; CARCINOMA; BIOPSY; ANASTROZOLE; THICKNESS; LESIONS;
D O I
10.1016/j.jmig.2019.08.007
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Study Objective: The primary aim of our study was to investigate the incidence of endometrial pathologies, especially endometrial cancer, in women with breast cancer treated with tamoxifen (TAM), aromatase inhibitors (AIs), or receiving no treatment (NT). The secondary aim was to identify, in this cohort, ultrasonographic findings that represent robust indications for hysteroscopy and endometrial biopsy, to avoid unnecessary second-level diagnostic procedures. Design: Multicenter retrospective cohort study (Clinical Trial ID: NCT03898947). Setting: Data were collected from different Italian centers: Regina Elena National Cancer Institute of Rome, Arbor Vitae Centre of Rome, Gaetano Martino University Hospital of Messina, and Villa Sofia-Cervello Hospital of Palermo. Patients: We selected and consecutively included patients with a history of breast cancer who had undergone hysteroscopy for ultrasonographic or clinical indications between January 2007 and December 2016. Interventions: Diagnostic hysteroscopy with endometrial biopsy or operative hysteroscopy, when clinically indicated. Measurements and Main Results: A higher percentage of patients in the TAM and AI groups had a normal endometrium compared with those in the NT group, whereas the incidence of endometrial polyps was higher in the NT group than in the others; no significant differences were observed among the 3 groups for other benign conditions or for premalignant and malignant uterine diseases, such as endometrial atypical hyperplasia and adenocarcinoma. Conclusion: TAM treatment does not seem to be associated with a higher rate of endometrial cancer in women with breast cancer compared with women treated with AIs or NT. (C) 2019 AAGL. All rights reserved.
引用
收藏
页码:832 / 839
页数:8
相关论文
共 35 条
[11]   Tamoxifen use and endometrial lesions: hysteroscopic, histological, and immunohistochemical findings in postmenopausal women with breast cancer [J].
Dibi, Raquel P. ;
Zettler, Claudio G. ;
Pessini, Suzana A. ;
Ayub, Alice V. ;
de Almeida, Suzane B. ;
da Silveira, Gustavo P. G. .
MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY, 2009, 16 (02) :293-300
[12]   Transvaginal ultrasonography and endometrial changes in postmenopausal breast cancer patients receiving tamoxifen [J].
Dijkhuizen, FPHLJ ;
Brolmann, HAM ;
Oddens, BJJ ;
Roumen, RMH ;
Coebergh, JWW ;
Heintz, APM .
MATURITAS, 1996, 25 (01) :45-50
[13]  
Dowsett M, 1995, CLIN CANCER RES, V1, P1511
[14]   Gene expression profiling of tamoxifen-associated uterine cancers: evidence for two molecular classes of endometrial carcinoma [J].
Ferguson, SE ;
Olshen, AB ;
Viale, A ;
Awtrey, CS ;
Barakat, RR ;
Boyd, J .
GYNECOLOGIC ONCOLOGY, 2004, 92 (02) :719-725
[15]  
FORNANDER T, 1989, LANCET, V1, P117
[16]   Prospective longitudinal study of ultrasound screening for endometrial abnormalities in women with breast cancer receiving tamoxifen [J].
Fung, MFK ;
Reid, A ;
Faught, W ;
Le, T ;
Chenier, C ;
Verma, S ;
Brydon, E ;
Fung, KFK .
GYNECOLOGIC ONCOLOGY, 2003, 91 (01) :154-159
[17]   Pretreatment and prospective assessment of endometrium in menopausal women taking tamoxifen for breast cancer [J].
Garuti, Giancarlo ;
Grossi, Francesco ;
Centinaio, Giovanna ;
Sita, Giulia ;
Nalli, Giulio ;
Luerti, Massimo .
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2007, 132 (01) :101-106
[18]   Influence of anastrozole (Arimidex), a selective, non-steroidal aromatase inhibitor, on in vivo aromatisation and plasma oestrogen levels in postmenopausal women with breast cancer [J].
Geisler, J ;
King, N ;
Dowsett, M ;
Ottestad, L ;
Lundgren, S ;
Walton, P ;
Kormeset, PO ;
Lonning, PE .
BRITISH JOURNAL OF CANCER, 1996, 74 (08) :1286-1291
[19]   Anastrozole versus tamoxifen treatment in postmenopausal women with endocrine-responsive breast cancer and tamoxifen-induced endometrial pathology [J].
Gerber, B ;
Krause, A ;
Reimer, T ;
Mylonas, I ;
Makovitzky, J ;
Kundt, G ;
Janni, W .
CLINICAL CANCER RESEARCH, 2006, 12 (04) :1245-1250
[20]   Comparison of ultrasonography, hysteroscopy, and biopsy in the diagnosis of endometrial lesions in postmenopausal tamoxifen-treated patients [J].
Giorda, G ;
Crivellari, D ;
Veronesi, A ;
Perin, T ;
Campagnutta, E ;
Carbone, A ;
Scarabelli, C .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2002, 81 (10) :975-980