Yıldız ERHAN, Osman ZEKİOĞLU, Coşan Mustafa TEREK, Levent AKMAN, Aydın ÖZSARAN, Yılmaz DİKMEN, Fatih ŞENDAĞ

Endometrial neoplasia with adjuvant tamoxifen treatment in breast cancer patients: Report of non-endometrioid subtypes

Bu çalışmanın amacı, meme kanserli hastalarda adjuvan tamoksifen tedavisi sonrasında gelişen endometrial kanserin klinik ve patolojik özelliklerini sunmaktır. Kliniğimizde; 1994 ve 2002 yılları arasında, meme kanseri nedeniyle tamoksifen kullanımı sonrasında endometrial kanser tanısı ile tedavi edilen yedi hastayı inceledik. Hastaların tıbbi bilgilerini retrospektif olarak değerlendirdik. Bütün hastalar postmenapozal dönemdeydi ve bir hasta nullipardı. Endometrial kanser, hastalarda 53-78 yaş arasında ortaya çıkmıştır. Hastaların menapoz yaşları 40-53 yaş arasındadır. Yedi postmenapozal hastanın altısında, ilk şikayet postmenapozal uterin kanamadır. Sadece bir hastada endometrial kanser yıllık jinekolojik muayane sırasında saptanmıştır. Tüm hastalarda endometrial kanser tanısı dilatasyon ve küretaj ile konmuştur. Hastalar 1-14 yıl arasında, günlük 20 mg tamoksifen ile tedavi edilmiştir. Altı hastada, adjuvan tamoksifen tedavisi sırasında endometrial kanser saptanmıştır.

Anahtar Kelimeler:

Dilatasyon ve küretaj, Endometriyum neoplazmları, Tamoksifen, Geriyedönük çalışma, Meme neoplazmları

Adjuvan tamoksifen tedavisi alan meme kanserli hastalarda endometrial neoplazi: Non-endometrioid alt gruplarının sunumu

The aim of the present study is to report the clinicopathologic features of endometrial cancers subsequently developed after adjuvant treatment of breast cancer with tamoxifen. Seven endometrial cancers in tamoxifen-treated breast cancer patients were treated at our institution between 1994 and 2002. Medical reports of the patients were evaluated retrospectively. All patients were postmenopausal and one patient was nulliparous. The age at discovery of the endometrial carcinoma ranged from 53-78. The menopausal age ranged from 40-53. Six of seven postmenopausal patients had postmenopausal uterine bleeding as the initial complaint. Only one patient was found to have endometrial cancer at annual gynecologic examination. Endometrial neoplasia was diagnosed by dilatation and curettage in all cases. The patients had been treated with 20 mg of tamoxifen daily for 1-14 years. Six patients were found to have endometrial carcinoma during adjuvant tamoxifen treatment. Only one patient developed endometrial carcinoma six years after the cessation of adjuvant tamoxifen treatment. Histopathologic examination of the specimens revelaed five cases of adenocarcinoma and two cases of sarcoma. Malignant mixed mesodermal tumor and adenosarcoma of the endometrium developed in long-term tamoxifen users (8 and 14 years, respectively). Patients with breast cancer using adjuvant tamoxifen treatment, especially the long-term users should be monitored for the possibility of endometrial neoplasia. It is notable that five out of seven endometrial malignancies were not of endometrioid subtype.

Keywords:

Dilatation and Curettage, Endometrial Neoplasms, Tamoxifen, Retrospective Studies, Breast Neoplasms,

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