Does tamoxifen use affect prognosis in breast cancer patients who develop endometrial cancer?

Obstet Gynecol. 2004 Aug;104(2):255-60. doi: 10.1097/01.AOG.0000131620.67911.03.

Abstract

Objective: The use of tamoxifen to prevent breast cancer and decrease recurrence is not controversial. However, the effect that tamoxifen may have in women with a history of breast cancer in whom endometrial cancer develops is unclear. The purpose of this study was to estimate whether a history of tamoxifen use is a prognostic factor for such patients.

Methods: Between 1990 and 2002, patients seen at The University of Texas M. D. Anderson Cancer Center with a history of breast cancer who developed endometrial cancer were identified. Medical records were reviewed to identify clinical, pathologic, and outcome information.

Results: Eighty-nine patients with a history of breast cancer in whom endometrial carcinoma developed were identified. Fifty-two percent (46/89) had a history of tamoxifen use (median duration 48 months; range 2-120 months). There were no significant differences in the clinical or pathologic features between tamoxifen users and nonusers. A history of tamoxifen use was associated with a shorter interval from breast cancer to endometrial cancer diagnosis (77.2 versus 121.3 months for nonusers; P =.01). There was no significant difference in overall survival between tamoxifen users and nonusers (39.2 months versus 48.3 months, P =.27), and there was no difference in endometrial cancer-specific survival duration between tamoxifen users and nonusers (55.7 versus 51.0 months, P =.92).

Conclusion: Among tamoxifen users, the interval from breast cancer to endometrial cancer diagnosis was significantly shorter than that in nonusers. In this cohort, a history of tamoxifen use was not associated with a worse overall or disease-specific survival.

MeSH terms

  • Adenocarcinoma, Clear Cell / epidemiology
  • Adenocarcinoma, Clear Cell / etiology
  • Adenocarcinoma, Clear Cell / mortality
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / adverse effects*
  • Breast Neoplasms / prevention & control*
  • Carcinoma, Endometrioid / epidemiology
  • Carcinoma, Endometrioid / etiology
  • Carcinoma, Endometrioid / mortality
  • Cystadenocarcinoma, Serous / epidemiology
  • Cystadenocarcinoma, Serous / etiology
  • Cystadenocarcinoma, Serous / mortality
  • Disease-Free Survival
  • Endometrial Neoplasms / epidemiology*
  • Endometrial Neoplasms / etiology
  • Endometrial Neoplasms / mortality
  • Female
  • Humans
  • Medical Records
  • Middle Aged
  • Mixed Tumor, Mullerian / epidemiology
  • Mixed Tumor, Mullerian / etiology
  • Mixed Tumor, Mullerian / mortality
  • Registries
  • Retrospective Studies
  • Survival Analysis
  • Tamoxifen / adverse effects*
  • Texas / epidemiology

Substances

  • Antineoplastic Agents, Hormonal
  • Tamoxifen