Aromatase inhibitors reverse tamoxifen induced endometrial ultrasonographic changes in postmenopausal breast cancer patients
Aromatase inhibitors may decrease endometrial thickness in breast cancer patients previously having short-term tamoxifen treatment. There is a necessity to find out if aromatase inhibitors can also decrease endometrial thickness in patients previously treated with long-term tamoxifen treatment.
Prospective comparison of the last ultrasonographic endometrial thickness measurement taken before discontinuation of long-term tamoxifen treatment in 36 postmenopausal breast cancer patients, with further measurements, performed following aromatase inhibitors administration.
There was a significant decrement of endometrial thickness, following 36.2 ± 16.8 months of tamoxifen treatment, from a mean value of 9.1 ± 5.8 mm, measured at the last ultrasonographic measurement performed before discontinuation of tamoxifen treatment, down to a mean value of 6.0 ± 5.0 mm, measured following 5.8 ± 5.8 months of aromatase inhibitors therapy (P = 0.001). A second ultrasonographic measurement performed in 8 patients following of additional 7.5 ± 4.0 months of aromatase inhibitors treatment revealed further decrement of mean endometrial thickness to 4.8 ± 2.1 mm (P = 0.002 compared to baseline).
In 28 patients (77.8%), endometrial thickness was reduced following the administration of aromatase inhibitors, in four patients (11.1%) there was no change in endometrial thickness and four (11.1%) patients demonstrated an increase of endometrial thickness.
Aromatase inhibitors may reverse endometrial thickening induced by long-term tamoxifen treatment in postmenopausal breast cancer patients.
KeywordsEndometrial thickness Aromatase inhibitors Tamoxifen Ultrasound
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We thank Mrs. Marilyn Benson for her editorial assistance.
- 1.Early Breast Cancer Trialists’ Collaborative Group (1992) Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. Lancet 339:1–71Google Scholar
- 4.Cohen I, Rosen DJD, Tepper R, et al (1993) Ultrasonographic evaluation of the endometrium with correlation to endometrial sampling in postmenopausal patients treated with tamoxifen. J Ultrasound Med 5:275–280Google Scholar
- 18.Ciato S, Cecchini S, Bonardi R, et al (1994) Ultrasonographic surveillance of endometrium in breast cancer patients on adjuvant tamoxifen. Lancet 244:260Google Scholar
- 22.Cohen I, Beyth Y, Azaria R, et al (2000) Ultrasonographic measurement of endometrial changes following discontinuation of tamoxifen treatment in postmenopausal breast cancer patients. Brit J Obstet Gynecol 107:1083–1087Google Scholar
- 26.Menada MV, Papadia A, Lorenzi P, et al (2004) Modification of ultrasonographically measured endometrial thickness after discontinuation of adjuvant therapy with tamoxifen in postmenopausal breast cancer patients. Eur J Gynaec Oncol 25:321–323Google Scholar
- 28.The ATAC (Arimidex Tamoxifen Alone or in Combination) Trialists’ Group (2002) Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomized trial. Lancet 359:2131–2139CrossRefGoogle Scholar
- 31.Garrone O, Mezi S, Occelli M, Ortu B, Favilla A, Schere L, Bertolotti P, Rizzo A, Rinaldi M, Merlano N, Crosseto N, et al (2003) Reversal of tamoxifen induced endometrial modifications by switching to letrozole in early breast cancer patients A prospective transvaginal ultrasound study (TVUS). Ann Oncol 14 (Suppl 4):iv7 (Abstr A22)Google Scholar
- 33.Berliere M, Galant C, Charles A, et al (2002) Endometrial evaluation is a very important tool in the management of breast cancer patients. Eur J Cancer (Suppl) 6:S67–S68Google Scholar
- 35.Ferguson SE, Solow RA, Amsterdam A, et al (2006) Comparison of uterine malignancies that develop during and following tamoxifen therapy. Gynecol Oncol 101:322--326Google Scholar