Endometrial cancer risk in postmenopausal breast cancer patients treated with tamoxifen or aromatase inhibitors

Background: Aromatase inhibitors (AIs) represent an effective endocrine treatment for hormone receptor-positive postmenopausal breast cancer patients with early stage or metastatic disease.Objective: Assessment of Cardiotoxicity in Hormone positive Postmenopausal Breast Cancer Patients receiving AIs (upfront orswitch therapy).Methods: This cross sectional study included 123 postmenopausal breast cancer patients presented to the Clinical Oncology Department, Ain Shams University (Cairo, Egypt) in the interval from August 2016 to June 2017 with hormone receptor positive receiving Aromatase Inhibitors, To assess cardiotoxicity in these patients, they were subjected to blood pressure and lipid profile measurement, electrocardiography (ECG), and electrocardiography (ECHO) and classified into patients had Nolvadex then A.I (arm 1) and others had upfront A.I (arm 2).Results: The age of patients ranged from 41 years to 85 years with mean age of 61 years. Seventy one patients (57.7%) showed cardiotoxicity as assessed by ECHO. They showed significant correlation with rising age above 62 years, IHD, history of HTN and DM (p value: .001, .001, .017 and 0.035 respectively). However, correlation between cardiotoxity and blood pressure changes, lipid profile changes and ECG findings and ECHO changes in switch therapy and upfront A.I were not statistically significant (p value = .275, .116, .081 and .761 respectively).Conclusion: Assessment of cardiotoxicity in hormone positive postmenopausal breast cancer patients receiving Aromatase Inhibitors showed evidence of cardiotoxicity in half the patients (57.7%) as detected by ECHO only. They showed statistically non significant correlations either recievied switch therapy or upfront A.I.

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Abstract P5-11-10: Gonadotropins Plasma Levels Are Significantly Influenced by Body Mass Index in Postmenopausal Breast Cancer Patients Undergoing Endocrine Therapy with Aromatase Inhibitors: Is This a Surrogate Marker for Serum Estrogen Bioactivity?

10.1158/0008-5472.sabcs10-p5-11-10 ◽

2010 ◽

Author(s):

M Hubalek ◽

A Oberguggenberger ◽

B Beer ◽

V Meraner ◽

H Oberacher ◽

...

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Cancer Patients ◽

Endocrine Therapy ◽

Body Mass ◽

Aromatase Inhibitors ◽

Plasma Levels ◽

Surrogate Marker ◽

Postmenopausal Breast Cancer ◽

Breast Cancer Patients

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Risk of Endometrial Cancer in Breast Cancer Patients under Long-Term Adjuvant Treatment with Tamoxifen

Tumori Journal ◽

10.1177/030089169808400104 ◽

1998 ◽

Vol 84 (1) ◽

pp. 21-23 ◽

Cited By ~ 9

Author(s):

Silvia Cecchini ◽

Stefano Ciatto ◽

Rita Bonardi ◽

Antonia Mazzotta ◽

Paolo Pacini ◽

...

Keyword(s):

Breast Cancer ◽

Endometrial Cancer ◽

Cancer Patients ◽

Endometrial Thickness ◽

Postmenopausal Breast Cancer ◽

Cancer Surveillance ◽

Tamoxifen Treatment ◽

Adjuvant Tamoxifen ◽

Breast Cancer Patients

Aims To evaluate the relative risk of endometrial cancer with respect to the expected underlying incidence in breast cancer patients undergoing long-term adjuvant tamoxifen therapy. Methods A total of 1010 postmenopausal breast cancer patients receiving adjuvant tamoxifen and with a first negative endometrial ultrasonography (cutoff for abnormal endometrial thickness >5 mm) were followed by annual transvaginal ultrasonography. Abnormal endometrial thickness prompted an outpatient endometrial biopsy or curettage under anesthesia in the case of cervical stenosis and increasing endometrial thickness. The standardized incidence ratio (SIR) with respect to underlying incidence was determined. Results A total of 1,010 eligible subjects who had been receiving tamoxifen for an average of 51 months were enrolled and followed for a total of 2,361 patient-years between January 1993 and December 1996. Five cases of endometrial cancer were observed in the study period: 1 was detected at screening, and 4 were diagnosed for vaginal bleeding in the interval between screening examinations. SIR was 4.0 (95% confidence interval, 1.39.4) and increased to 4.8 (CI, 1.6-10.5) when the single cancer detected at first screening was considered as incident. Conclusions This study adds evidence to the hypothesis that long-term tamoxifen treatment may be responsible for a relevant increase in the risk of developing endometrial cancer. Surveillance based on endometrial ultrasonography was poorly sensitive, but the favorable stage at diagnosis of screen-detected or interval endometrial cancers does not support a more aggressive screening approach.

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