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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-four patients with endometrial carcinoma received tamoxifen (Nolvadex) for 7 days. Before and after administration, circulating hormones (estradiol, testosterone, progesterone, gonadotropins FSH and LH) were evaluated. Estrogen (ER) and progesterone receptors (PgR) in neoplastic tissue were also assayed. Our results show a net increase in PgR content and a significant decrease in gonadotropin levels after the treatment. The authors suggest that clinical trials be conducted using tamoxifen and progestins for adjuvant therapy after surgery of endometrial carcinoma and for the therapeutic approach of advanced carcinoma.
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PMID:Hormonal and receptor status in postmenopausal women with endometrial carcinoma before and after treatment with tamoxifen. 642 17

Tamoxifen (Nolvadex), a nonsteroidal antiestrogen, was first approved by the FDA for the treatment of patients with breast cancer in 1978. Large clinical trials have demonstrated a recurrence-free and overall survival benefit in both pre- and postmenopausal women. Long-term adjuvant tamoxifen is the endocrine treatment of choice for selected patients with breast cancer, and large-scale trials are currently underway to evaluate its role as a chemopreventive agent in healthy women at risk for breast cancer. Consequently, a large number of women will be subjected to both the benefits and potential risks of long-term tamoxifen therapy. One of the most significant potential complications is the development of endometrial cancer. The estimated annual risk of endometrial cancer in tamoxifen-treated patients is approximately 2 per 1,000 women. Most of these cancers will be detected at an early stage when they are highly curable. The potential benefit of tamoxifen treatment in breast cancer patients outweighs this risk; however, all patients receiving tamoxifen should undergo regular gynecologic evaluations.
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PMID:The effect of tamoxifen on the endometrium. 877 Oct 96

Various ongoing double-blind clinical trials are evaluating the use of tamoxifen (Nolvadex) as chemoprevention for breast cancer. A total of over 24,000 healthy women have been randomized to these trials, and it should be possible, by the year 2000, to detect any preventive effect of tamoxifen in healthy women. Furthermore, with the large numbers of women involved, it should be possible to evaluate prevention in subgroups of participants according to risk of the disease, particularly those women carrying high-risk genes, such as BRCA1 and BRCA2. Adverse effects of tamoxifen have been identified, including a transient bone loss in premenopausal women and uterine effects, including polyps, cysts, and endometrial cancer, in postmenopausal women. Although the potential benefit of tamoxifen in preventing breast cancer in healthy women is likely to outweight any potential long-term risks, the use of other tamoxifen-like drugs, such as raloxifene (Evista) and toremifene (Fareston) is now being investigated.
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PMID:Status of antiestrogen breast cancer prevention trials. 955 88

Tamoxifen (Nolvadex), a selective estrogen-receptor modulator, or SERM, is currently the endocrine therapy of choice for all stages of hormone-responsive breast cancer. Only tamoxifen has been approved by the US Food and Drug Administration to reduce the incidence of breast cancer in high-risk women. Despite tamoxifen's antiestrogenic effects in breast tissue, it exhibits paradoxical estrogenic effects in other tissues in the body. These effects result in the maintenance of bone mineral density, but a three- to fourfold increase in endometrial cancer in postmenopausal women. Additionally, tamoxifen can result in troublesome hot flashes and serious thromboembolic events. For this reason, current research is focusing on new agents that may maintain the beneficial effects of tamoxifen while reducing its adverse effects. Raloxifene (Evista) is another SERM, approved for the prevention of osteoporosis in postmenopausal women and now being compared with tamoxifen in an ongoing breast cancer prevention trial. Like tamoxifen, raloxifene is associated with hot flashes and thromboembolic events, but its association with the risk of endometrial cancer is unknown. A number of new SERMs are in preclinical or clinical development in an attempt to improve upon the safety profile of tamoxifen. Additionally, selective aromatase inhibitors are being examined in the early breast cancer setting.
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PMID:Selective estrogen-receptor modulators in 2001. 1158 65

Estrogens act through specific receptors located in the nuclei of epithelial and stromal cells of the endometrium. Estrogens stimulate the synthesis of these receptors and the progesterone inhibits their synthesis. Estrogens induce the proliferation of the mucosa during the proliferative phase. They also stimulate the synthesis of receptors for the progesterone, which is a prerequisite for progesterone activity. Hyperplasias most of the time do not contain cytological atypia and are developed under a hyperestrogenic background. They contain receptors for estrogen and progesterone, and are able to respond to progestogens. Hyperplasias with cytological atypia are precancerous lesions, associated with an hyperestrogenic or atrophic background. In the later case, they may be focal and are better diagnosed by hysteroscopy. They are best managed by simple hysterectomy. Progesterone may be used if the patient desires to conceive. Endometrial cancers are either associated with an hyperestrogenic or atrophic background. In the later case, they are often of serous or clear cell type. Endometrial effects of antiestrogens are known only for tamoxifene. Tamoxifene has an atrophic effect but sometimes may induce an estrogenic stimulation of the endometrial mucosa through the alpha and beta estrogenic receptors. Polyp is the most frequent abnormality diagnosed but endometrial cancer is significantly more frequently diagnosed than in a control population. It is well differentiated and does not modify the survival of the patient.
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PMID:[Effect of estrogens and antiestrogens on the endometrium]. 1266 Dec 81

The current recommended adjuvant therapy for oestrogen receptor-positive breast cancer typically includes 20 mg/day tamoxifen (Nolvadex) for 5 years post-operatively. This regimen has been found to reduce the incidence of contralateral breast cancer in breast cancer survivors by 47%, and, when used prophylactically, to reduce new breast cancers in high risk women by 49%. However, epidemiological evidence links tamoxifen therapy to increases in endometrial cancer and thromboembolic events in breast cancer patients. In addition, in tamoxifen-exposed rats dose-related increases in hepatic tamoxifen-DNA adduct formation and liver tumour incidence occur through a classic genotoxic mechanism. In women, endometrial cancers may be the result of genotoxicity, hormonally induced signal transduction and/or other mechanisms. If genotoxicity is relevant to tamoxifen-induced endometrial cancer it may be possible to identify women at risk through detection of tamoxifen-DNA adducts. The aim of this one day conference was to examine the most recent evidence for the occurrence of tamoxifen-induced genotoxicity in women receiving tamoxifen therapy. There were significant experimental differences, as some participants presented evidence for a genotoxic mechanism, while others reported finding insufficient evidence to support a genotoxic mechanism. The discussion was wide ranging and the outcome underscored the need for further investigations, access to more human tissue samples, shared tamoxifen-DNA standards for methodological comparisons and inter-laboratory exchange of human tissue samples.
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PMID:The genotoxicity of tamoxifen: extent and consequences, Kona, Hawaii, January 23, 2003. 1284 Jan 14

The objectives of this study were to: 1) characterize histologically endometrial biopsy findings for genital bleeding in breast cancer patients receiving Tamoxifen; 2) analyze histologically endometrial carcinoma in the same patients. We analyzed biopsy specimens divided into three groups: 1) 112 biopsies (curettages and hysterectomy specimens) from 88 breast cancer patients receiving Tamoxifen (Nolvadex): T+; 2) 27 biopsies (curettages and hysterectomy specimens) from 22 breast cancer patients not receiving Tamoxifen but biopsied for genital bleeding: T-; 3) 139 curettages control samples received for analysis in the period January-March 2000 from women with peri- and postmenopausal genital bleeding: K. The analysis was performed on archival H&E sections. The most frequent finding in breast cancer patients receiving Tamoxifen was endometrial polyp. Compared with the other two groups (T- and K) the frequency of this finding was statistically significant. No difference was found in the prevalence of endometrial cancer between the three groups. The analyzed endometrial carcinomas in Tamoxifen-treated breast cancer patients show signs, characteristic of Bochman type I: predominantly endometrioid, of low grade and FIGO stage, with good prognosis.
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PMID:[Pathology of the endometrium in breast cancer patients treated with tamoxifen (nolvadex)]. 1468 5

Endometrial polyps are the most common endometrial pathology described in association with Tamoxifen exposure. The aim of this study was to evaluate the malignant potential of endometrial polyps in breast cancer patients receiving Tamoxifen. We analyzed 140 endometrial polyps divided into two groups: 1) 73 endometrial polyps from 57 breast cancer patients receiving Tamoxifen (Nolvadex): T+ endometrial polyps; 2) 67 control endometrial polyps received for analysis in the period January-December 2000. The analysis was performed on archival H&E sections. We found that the rates of endometrial carcinoma and atypical hyperplasia were high in patients treated with Tamoxifen (7.02% vs 2.99% and 17.54% vs 11.94%), but the results did not reach statistical significance (p > 0.05).
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PMID:[Histological analysis of endometrial polyps in breast cancer patients treated with tamoxifen (nolvadex)]. 1518 27

Five years of adjuvant therapy with tamoxifen was considered the gold-standard treatment for postmenopausal women with estrogen receptor-positive breast cancer for many years. Data from a core group of clinical trials investigating the safety and efficacy of aromatase inhibitors (AIs) have challenged this perception. These studies were designed to evaluate the safety and efficacy of AIs in the following clinical settings: 1) as initial adjuvant therapy (the Arimidex, Tamoxifen, Alone or in Combination trial, Breast International Group Trial 1-98), 2) in a "switched setting" after 2 to 3 years of treatment with tamoxifen (Arimidex-Nolvadex 95, the Austrian Breast and Colorectal Cancer Study Group 8 [ABCSG 8] trial, the Italian Tamoxifen Anastrozole study, the Intergroup Exemestane Study), and 3) in extended settings (National Cancer Institute of Canada Trial MA.17, ABCSG 6a, National Surgical Adjuvant Breast and Bowel Project 33). The efficacy data from these studies suggested that AIs have added substantial benefit in terms of disease outcome. AIs were tolerated well, and patients who received them experienced fewer thrombolic events and less endometrial cancer, hot flashes, night sweats, and vaginal bleeding compared with patients who receive tamoxifen. However, patients who received tamoxifen had less skeletal events and accelerated bone resorption compared with women who received AIs. AIs should be considered when planning a patient's endocrine therapy, taking into account the differences in tolerability and end-organ effects of the classes of endocrine therapy. Outstanding issues to optimize AI therapy include identifying the optimal duration, agent, and patients for these therapies.
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PMID:Summary of aromatase inhibitor clinical trials in postmenopausal women with early breast cancer. 1807 56