Skip to main content
SpringerLink
Log in

Association between endometrial cancer and tamoxifen treatment of breast cancer

  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

A retrospective cohort‐study in 4109 breast cancer patients was undertaken to determine how tamoxifen affected the risk of endometrial cancer. Data on 1701 tamoxifen‐treated women were analysed. Two thousand four hundred and eight non‐tamoxifen users served as control group. The occurrence of new primary uterine cancers was assessed by computerized linkage to the Austrian Cancer Registry. Twenty‐five women who subsequently developed endometrial cancer were identified. Eight uterine cancers occurred in the tamoxifen group, whereas 17 uterine cancers were found in the control group. The estimate of the relative risk (RR) showed an increased risk to develop endometrial cancer for the tamoxifen group RR 1.136 (95% CI 0.71; 1.80). Analysis of relevant confounding variables did not show any differences in the two groups.

In conclusion, this retrospective study demonstrated a non‐significant increased risk of endometrial cancer in women receiving tamoxifen as treatment for breast cancer. However, the magnitude of RR and the absolute number of endometrial cancer cases in this long term observation demonstrate clearly that the clinical benefit of tamoxifen therapy greatly outweighs the risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Early Breast Cancer Trialists' Collaborative Group: Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy: 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Lancet 339: 1–15, 71–85, 1992

    Google Scholar 

  2. Breast Cancer Trials Committee, Scottish Cancer Trials Office (MRC), Edinburgh: Adjuvant tamoxifen in the management of operable breast cancer: The Scottish Trial. Lancet ii: 171–175, 1987

  3. Fisher B, Constantino J, Redmond C, Poisson R, Bowman D, Couture J, Dimitrov N, Wolmark N, Wickerham DL, Fisher ER, Margolese R, Robioux A, Shibata H, Terz J, Paterson AHG, Feldman MI, Farrer W, Evans J, Lickley HL, Ketner M: A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors. N Engl J Med 320: 479–484, 1989

    Google Scholar 

  4. Love RR: Tamoxifen prophylaxis in breast cancer. Oncology (Willston Park) 6: 33–43, 1992

    Google Scholar 

  5. Fisher B, Redmond C: New perspective on cancer of the contralateral breast: a marker for assessing tamoxifen as a preventing agent. J Natl Cancer Inst 83: 1278–1280, 1991

    Google Scholar 

  6. Powles TJ: The case for clinical trials of tamoxifen for prevention of breast cancer. Lancet 340: 1145–1147, 1992

    Google Scholar 

  7. Fornander T, Rutqvist LE, Cedermark B, Glas U, Mattson A, Silverswärd C, Skoog L, Somell A, Theve T, Wilking N, Askergren J, Hjalmar ML: Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers. Lancet i: 117–120, 1989

    Google Scholar 

  8. Gusberg SB: Tamoxifen for breast cancer: associated endometrial cancer. Cancer 65: 1463–1464, 1990

    Google Scholar 

  9. Killackey MA, Hakes TB, Pierce VK: Endometrial adenocarcinoma in breast cancer patients receiving antiestrogens. Cancer Treat Rep 69: 237–238, 1985

    Google Scholar 

  10. Jordan VC: Tamoxifen and endometrial cancer. Lancet ii: 1019, 1988

  11. Hardell L: Tamoxifen as a risk factor for carcinoma of corpus uteri. Lancet ii: 563, 1988

    Google Scholar 

  12. Atlante G, Pozzi M, Vincenzoni C, Vocature G: Four case reports presenting new acquisitions on the association between breast and endometrial carcinoma. Gynecol Oncol 37: 378–380, 1990

    Google Scholar 

  13. Malfetano JH: Tamoxifen-associated endometrial carcinoma in postmenopausal breast cancer patients. Gynecol Oncol 39: 82–84, 1990

    Google Scholar 

  14. Spinelli G, Bardazzi N, Citernesi A, Fontanarosa M, Curiel P: Endometrial carcinoma in tamoxifen-treated breast cancer patients. J Chemother 3: 267–270, 1991

    Google Scholar 

  15. De Muylder X, Neven P, De Sommer M, Van Belle Y, Vanderick G, De Muylder E: Endometrial lesions in patients undergoing tamoxifen therapy. Int J Gynaecol Obstet 36: 127–130, 1991

    Google Scholar 

  16. Van Leeuwen FE, Benraadt J, Coebergh JWW, Kiemeney LALM, Gimrere CHF, Otter R, Schouten LJ, Damhuis RAM, Bontenbal M, Diepenhorst FW, van den Belt-Dusebout AW, van Tinteren H: Risk of endometrial cancer after tamoxifen treatment of breast cancer. Lancet 343: 448–452, 1994

    Google Scholar 

  17. Mathew A, Chabon AB, Kabakow B, Drucker M, Hirschmann RJ: Endometrial carcinoma in five patients with breast cancer on tamoxifen therapy. NY State J Med 90: 207–208, 1990

    Google Scholar 

  18. Andersson M, Storm HH, Mouridsen HT: Incidence of new primary cancers after adjuvant tamoxifen therapy and radiotherapy for early breast cancer. J Natl Cancer Inst 83: 1013–1017, 1991

    Google Scholar 

  19. Andersson M, Storm HH, Mouridsen HT: Carcinogenic effects of adjuvant tamoxifen treatment and radiotherapy for early breast cancer. Acta Oncol 31: 259–263, 1992

    Google Scholar 

  20. Seud MAF, Johnson J, Weed JC: Gynecologic tumors in tamoxifen-treated women with breast cancer. Obstet Gynecol 82(2): 165–169, 1993

    Google Scholar 

  21. Stewart H, Knight GM: Tamoxifen and the uterus and endometrium. Lancet 1: 375–376, 1989

    Google Scholar 

  22. Neven P, De Muylder X, VanBelle Y, Vanderick G, De Muylder E: Tamoxifen and the uterus and endometrium. Lancet i: 375, 1989

    Google Scholar 

  23. Nolvadex Adjuvant Trial Organization: Controlled trial of tamoxifen as a single agent in the management of early breast cancer. Br J Cancer 57: 608–611, 1988

    Google Scholar 

  24. Nayfield SG, Karp JE, Ford LG, Dorr FA, Kramer BS: Potential role of tamoxifen in prevention of breast cancer. J Natl Cancer Inst 83: 1450–1459, 1991

    Google Scholar 

  25. Ribeiro G, Swindell R: The Christie hospital adjuvant tamoxifen trial – status at 10 years. Br J Cancer 57: 601–603, 1988

    Google Scholar 

  26. Bundesministerium für Gesundheit, Sport und Konsumentenschutz: Krebsstatistik. Bericht über das Gesundheitswesen in Österreich im Jahre 1993. Österreichische Staatsdruckerei, Wien, 1994

  27. Kurman RJ: Blaustein's Pathology of the Female Genital Tract, 3rd edn. Springer-Verlag, New York, 1987

    Google Scholar 

  28. Creasman WT: New gynecologic cancer staging. Obstet Gynecol 75: 287–288, 1990

    Google Scholar 

  29. American Joint Committe on Cancer: Handbook for Staging of Cancer, 4th edn. J. B. Lippincott Company, Philadelphia, 1993

  30. Kleinbaum DG, Kuppes LL, Morgenstern H: Epidemiologic Research. Van Nostrand Reinhold, New York, 1991

    Google Scholar 

  31. Woolf B: On estimating the relationship between blood group and disease. Annals Human Genet 19: 251–253, 1955

    Google Scholar 

  32. Peters-Engl CH, Medl M, Danmayr E, Mirau M, Alth G, Leodolter S: Endometrial cancer after tamoxifen treatment: a descriptive study of 25 breast cancer patients who subsequently developed endometrial cancer. Anticancer Res 16: 3241–3246, 1996

    Google Scholar 

  33. Margriples U, Naftolin F, Schwartz PE, Carcangiu ML: Highgrade endometrial carcinoma in tamoxifen-treated breast cancer patients. J Clin Ocol 11: 485–490, 1993

    Google Scholar 

  34. Boccardo F, Bruzzi P, Rubagotti A, Nicolo G, Rosso R: Estrogen-like action of tamoxifen on vaginal epithelial in breast cancer patients. Oncology 38: 281–285, 1981

    Google Scholar 

  35. Patterson JS: Clinical aspects and development of antiestrogen therapy: a review of the endocrine effects of tamoxifen in animals and man. J Endocrinol 89: 67–75, 1981

    Google Scholar 

  36. Gottardis MM, Robinson SP, Satyaswaroop PG, Jordan VC: Contrasting actions of tamoxifen on endometrial and breast tumor growth in the athymic mouse. Cancer Res 48: 812–815, 1988

    Google Scholar 

  37. Fisher B, Constantino JP, Redmond CK, Fisher ER, Wickerham DL, Cronin WM: Endometrial cancer in tamoxifentreated breast cancer patients: findings from the National Adjuvant Breast and Bowel Project (NSAPB-14). J Natl Cancer Inst 86: 527–537, 1994

    Google Scholar 

  38. Cook LS, Weiss NS, Schwartz SM, White E, McKnight B, Moore DE, Daling JR: Population-based study of tamoxifen therapy and subsequent ovarian, endometrial, and breast cancers. J Natl Cancer Inst 87: 1359–1364, 1995

    Google Scholar 

  39. Cohen I, Doron JD, Rosen JD, Shapira J, Cordoba M, Gilboa S, Altaras MM, Yigael D, Beyth Y: Endometrial changes with tamoxifen: Comparison between tamoxifen-treated and nontreated asymptomatic, postmenopausal breast cancer patients. Gynecol Oncol 52(2): 185–190, 1994

    Google Scholar 

  40. Kedar RP, Bourne TH, Powles TJ, Collins WP, Ashley SE, Cosgrove DO, Campbell S: Effects of tamoxifen on uterus and ovaries of postmenopausal women in a randomised breast cancer prevention trial. Lancet 343: 1318–1321, 1994.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Lainz Medical Center, Vienna, Austria

    Christian Peters‐Engl & Michael Medl

  2. Institute of Statistics and Computer Science, University of Vienna, Austria

    Wilhelm Frank

  3. Ludwig Boltzmann Institute for Clinical Oncology and Photo‐dynamic Therapy, Vienna, Austria

    Eberhard Danmayr

  4. Austrian Central Statistical Office, Vienna, Austria

    Hans P. Friedl

  5. Ludwig Boltzmann Institute for Gynecologic Oncology and Reproductive Medicine, Vienna, Austria

    Sepp Leodolter

Authors
  1. Christian Peters‐Engl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wilhelm Frank
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eberhard Danmayr
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans P. Friedl
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sepp Leodolter
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael Medl
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Peters‐Engl, C., Frank, W., Danmayr, E. et al. Association between endometrial cancer and tamoxifen treatment of breast cancer. Breast Cancer Res Treat 54, 255–260 (1999). https://doi.org/10.1023/A:1006126411210

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006126411210

Search

Navigation