Pathological Results And Related Influencing Factors Of Endometrial Disease Of Breast Cancer Patients After Taking Tomoxifen

Objective:By retrospectively analyzing the basic clinical data of postoperative patients with breast cancer and endometrial pathological results,the effects of tamoxifen treatment on endometrium were explored,Analysis of pathological changes in patients’ endometrium and related influencing factors leading to endometrial changes.To support the clinical development of individualized treatment plans for gynecological prevention of endometrial disease in patients with adjuvant endocrine therapy after breast cancer surgery.Methods:A total of 330 patients with gynecological problems such as abnormal vaginal bleeding or B-mode ultrasound suggesting endometrial abnormalities or uterine space occupation were collected from breast cancer patients who were treated in the gynecology department of our hospital from August 2010 to August 2019,SPSS 22.0 statistical software was used for statistical analysis to compare the pathological results of endometrial changes in patients with breast cancer after taking tamoxifen,and discuss the postoperative pathology of patients with endometrial cancer after taking medication,explore the impact of related factors on the endometrium.Results:1.The pathological types of endometrial lesions caused by tamoxifen after breast cancer surgery are mainly endometrial polyps,hyperplasia without atypia of the endometrium,endometrial myoma/adenomyoma,atypical hyperplasia of the endometrium,and endometrial cancer Of which endometrial polyps are the most frequently occurring lesion type(112/330,accounting for 33.94%).2.Among the 170 patients in the medication group,there were 135 lesions of the endometrium,accounting for 79.41%(135/170),and of the 160 patients in the non-medication group,there were 85 cases of lesions intima,accounting for 32.22%(85/160),chin-square test,Chi-square test analysis of the endometrial lesion rate in the two groups of patients,the results suggest that the difference is statistically significant(2=29.031,P=0.000),indicating that taking tamoxifen is more prone to endometrium than not taking tamoxifen.Lesions3.There were 30 cases of endometrial cancer in the medication group after surgery There were 9 patients with endometrial cancer in the untreated group.The incidence of endometrial cancer in the medication group was 17.65%(30/170).The group was 5.63%(9/160),and there was a statistical difference between the incidence of endometrial cancer in the two groups of patients(2=8.967,P=0.003),suggesting that the medication group had higher endometrial cancer than the untreated group rate.4.The incidence of type I endometrial cancer was 45.45%(10/22)higher than that of type Ⅱ endometrial cancer(54.55%(12/22)).The 6 patients in the untreated group were all type I endometrial cancer patients.The difference was statistically significant(P<0.05).The comparison of pathological analysis between the two groups of patients showed that the statistical results of histological classification,surgical pathological staging,peritoneal lavage fluid abnormal cells,myometrial invasion,and lymph node metastasis are shown in Table 2.There were no significant differences in endometrial cancer between the two groups.5.Menopausal status of patients and oral tamoxifen treatment time are factors affecting endometrial lesions(P<0.05).Logistic regression analysis was performed on the data.Menopausal status and time of postoperative medication and the occurrence of endometrial lesions in patients.There was a positive correlation.Patients in menopausal state were 6.971 times more likely to develop lesions than premenopausal patients,and patients who had been taking medicine for more than five years were 7.165 times more likely to develop endometrial lesions.There was no significant correlation between the age of the patient,the postoperative time of breast cancer,whether chemotherapy was performed,the thickness of the endometrium and the occurrence of endometrial lesions.Conclusions:1.Patients with breast cancer after taking tamoxifen treatment increase the risk of endometrial disease.The pathological types of endometrial disease include endometrial polyps,hyperplasia without atypia of endometrium,and endometrial fibroids/adenosine Neoplasms,atypical hyperplasia of endometrium,endometrial cancer,of which the incidence of endometrial polyps is higher2.Taking tamoxifen treatment increases the risk of endometrial cancer in patients with breast cancer after surgery,and the incidence of type II endometrial cancer is higher than that of type I endometrial cancer.3.Menopausal status and medication time are independent risk factors for endometrial lesions in patients.Postmenopausal women taking tamoxifen for breast cancer surgery have a higher risk of developing lesions than premenopausal patients,and the risk of endometrial disease increases significantly when the medication is taken for more than five years.4.For postoperative breast cancer patients treated with taking tamoxifen,the observation of gynecological symptoms and regular ultrasound examination should be strengthened,and an individualized plan should be formulated to achieve the early detection,early diagnosis and early treatment of endometrial disease,especially endometrial cancer..