| Objective: To investigate the impact and the related factors on endometrium of breast cancer patients after tamoxifen(TAM) taken, and provide a help on clinic medication safety and mornitoring. In order to provide a theoretical basis for endometrial lesion caused by tamoxifen.Methods:A retrospective summary of 76 postoperative breast cancer patients of TAM taken who admitted to gynecologic ward of General Hospital of Ningxia Medical University, between March 2008 to December 2014. The statistical analysis was performed by the general condition,clinical features, medication compliance, menstrual status,endometrium pathological changes and related factors.Results:1. Overall the 76 cases in the study, a total of 35 cases(35/76, 46.05%) for treatment of vaginal bleeding, which is the most commom reason. 2. According to the preoperative ultrasonography, endometrial examination results and postoperative pathological results, 60 patients(78.95%, 60/76) occurred endometrial lesions, such as: endometrial polyps, endometrial simple hyperplasia, endometrial atypical hyperplasia and endometrial carcinoma. In all the lesions, endometrial polyps are the most common lesion(61.67%,37/60). The postoperative pathologic examination of 9 patients with endometrial carcinoma showed: endometrial high differentiation adenocarcinoma IA period 4 cases, endometrial moderately-low differentiated adenocarcinoma IB period 2 cases, endometrial moderately differentiated adenocarcinoma IIB period 1 case, endometrial adeno squamous carcinoma IIA period 1 case, utrine papillary serous carcinoma(UPSC) IB period 1 case.3.29 patients in menopausal group, in which 18 cases had endometrial lesions(18/29,62.07%), including 1 cases of endometrial carcinoma(1/29,3.45%); 47 patients in postmenopausal group, in which 42 cases had endometrial lesions(42/47,89.36%), including 8 cases of endometrial carcinoma(8/47,17.02%). There were statistical significance in endometrial disease rate and canceration rate between the two groups. 4. Endometrial thickness <5mm in 19 cases, without the occurrence of endometrial cancer, 5-8mm in 38 cases, 2 cases of endometrial cancer(5.26%, 2/38),> 8mm 19 cases, 7 cases of endometrial cancer(36.84%, 7/19), the incidence of endometrial cancer has significant difference between the groups.5. The ammount of the patients is 71 which take the tamoxifen less than 5 years, including 6 cases of cancer(6/71,8.45%). And take the drug for more than 5 years a total of 5 cases, 3 cases of carcinogenesis among them(3/5,60.00%). The dose in 62 cases for 10-20mg/d, 6 cases occurred endometrial carcinogenesis(6/62,9.68%), 3 cases of patients with the dose of 30mg/ d, none of them had carcinogenesis, the dose of 11 cases of 40mg/d, 3 cases of carcinoma(3/11,27.27%).Conclusion:1. In patients with breast cancer after tamoxifen treatment, the most common clinical feature is irregular vaginal bleeding, followed by B ultrasound examination or diagnostic curettage found abnormal, the patient should pay attention to regular follow-up and typical clinical presentation during tamoxifen taken, so that we can find the lesion and treat it in time. 2. Taken tamoxifen can cause the endometrial lesions, include endometrial polyps, endometrial simple hyperplasia, endometrial atypical hyperplasia and endometrial carcinoma, endometrial polyps are the most common lesion. 3. Postmenopausal patients has the higher rate in endometrial lesion and canceration than menopausal patients after tamoxifen taken. 4. Intimal thickening is often suggested possibility of endometrial lesion. When the endometrial thickness over 5mm needs a further examination. 5. Taking tamoxifen for more than five years, the incidence ofendometrial cancer increased. The incidence of tamoxifen dose and endometrial cancer was no significant correlation. |
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