Tamoxifen-induced endometrial hyperplasia

Abstract

 

Breast cancer is the most common cancer among the female population. In the adjuvant therapy regimens for hormone-sensitive breast cancer, tamoxifen is one of the most common and cost-effective drugs. Despite the fact that the main therapeutic effect of tamoxifen is associated with its antiestrogenic activity, the drug also acts as an agonist of estrogen receptors in other tissues of the body, such as the endometrium. Side effects of taking tamoxifen may include endometrial proliferation, hyperplasia, polyps, invasive carcinoma, and uterine sarcoma. An outpatient obstetrician-gynecologist most often encounters all these conditions. The main difficulty in managing such patients lies in the absence of uniform algorithms for assessing and further treatment tactics for patients taking tamoxifen, which often leads to unjustified drug withdrawal or numerous surgical manipulations.

The literature on the effect of tamoxifen on endometrial tissue and possible algorithms for the management of patients with hyperplastic processes during therapy were analyzed.

In the search databases such as Web of Science, eLibrary, Scopus, and PubMed / MEDLINE authors selected articles for the period 1991–2023 devoted to the assessment of the effect of tamoxifen on the endometrial condition using the following keywords: “tamoxifen”, “hyperplasia”, “breast cancer”, “endometrial cancer”, and “assessment”. No methodological filter was used to exclude the omission of suitable articles. This study included full-text sources and literature reviews on the subject under study. Articles that were not directly related to the topic of breast cancer therapy with tamoxifen were excluded from the review. To avoid including duplicate publications therein, if we found two studies by the same authors, the study period of each author was assessed, and if the dates coincided, we selected the most recent publication.

It can be concluded that there are restrictions on the management tactics of patients faced with endometrial hyperplastic processes while taking tamoxifen. Many patients included in existing studies and case reports have variable factors that make direct analysis or comparison complicated, such as age, the presence of hypertension, body mass index, various reproductive periods in which patients experienced breast cancer, the duration of tamoxifen intake, and the frequency of pelvic ultrasound. However, this literature review summarizes the data of recent major studies that may clarify the criteria for assessing endometrial thickness while taking tamoxifen and possible options for managing patients during breast cancer therapy.

The following steps can improve the quality of medical care for patients with hyperplasia during tamoxifen therapy: awareness of the patient about possible hyperplastic processes during therapy; awareness that any episode of abnormal uterine bleeding is a reason to see a doctor; pelvic ultrasound before starting tamoxifen therapy; the ultrasound thickness of the endometrium is not a reliable criterion, however, elastosonography may be a more promising technique for identifying the risks of malignancy.

Keywords

tamoxifen / hyperplasia / breast cancer / endometrial cancer / assessment

References

[1] Kaprin AD, Starinskiy VV, Shahzadova AO, editors. Malignant neoplasms in Russia in 2021. Moscow: Moscow Oncology Research Institute named after P.A. Herzen; 2022. 239 p. (In Russ.)

[2] Состояние онкологической помощи населению России в 2021 году / под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. Москва: МНИОИ им. П.А. Герцена − филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2022. 239 с.

[3] Tyulyandin SA, Artamonova EV, Zhukova LG, et al. Practical recommendations for the drug treatment of breast cancer. Malignant tumors. 2023;13(3S2–1):157–200. EDN: VMPFLQ doi: 10.18027/2224-5057-2023-13-3s2-1-157-200

[4] Тюляндин С.А., Артамонова Е.В., Жигулев А.Н., и др. Практические рекомендации по лекарственному лечению рака молочной железы. Практические рекомендации RUSSCO, часть 1 // Злокачественные опухоли. 2023. Т. 13, № 3S2–1. С. 157–200. EDN: VMPFLQ doi: 10.18027/2224-5057-2023-13-3s2-1-157-200

[5] Reis-Filho JS, Tutt ANJ. Triple negative tumours: a critical review. Histopathology. 2008;52(1):108–118. doi: 10.1111/j.1365-2559.2007.02889.x

[6] Reis-Filho J.S., Tutt A.N.J. Triple negative tumours: a critical review // Histopathology. 2008. Vol. 52, N 1. P. 108–118. doi: 10.1111/j.1365-2559.2007.02889.x

[7] Kolyadina IV, Poddubnaya IV, Frank GA, et al. The prognostic value of the tumor receptor status in early breast cancer. Modern technologies in medicine. 2012;(4):48–53. EDN: PUVLYD

[8] Колядина И.В., Поддубная И.В., Франк Г.А., и др. Прогностическое значение рецепторного статуса опухоли при раннем раке молочной железы // Современные технологии в медицине. 2012. № 4. С. 48–53. EDN: PUVLYD

[9] Gradishar WJ, Moran MS, Abraham J, et al. NCCN guidelines® insights: breast cancer, version 4.2023: featured updates to the NCCN guidelines. JNCCN. 2023;21(6):594–608. EDN: ALVOFG doi: 10.6004/jnccn.2023.0031

[10] Gradishar W.J., Moran M.S., Abraham J., et al. NCCN guidelines® insights: breast cancer, version 4.2023: featured updates to the NCCN guidelines // JNCCN. 2023. Vol. 21, N 6. P. 594–608. EDN: ALVOFG doi: 10.6004/jnccn.2023.0031

[11] Jones MЕ, van Leeuwen FE, Hoogendoorn WE, et al. Endometrial cancer survival after breast cancer in relation to tamoxifen treatment: pooled results from three countries. Breast Cancer Res. 2012;14:1–11. doi: 10.1186/bcr3206

[12] Jones M.E., van Leeuwen F.E., Hoogendoorn W.E., et al. Endometrial cancer survival after breast cancer in relation to tamoxifen treatment: pooled results from three countries // Breast Cancer Res. 2012. Vol. 14. P. 1–11. doi: 10.1186/bcr3206

[13] Chia SK, Wolff AC. With maturity comes confidence: EBCTCG tamoxifen update. Lancet. 2011;378(9793):747–749. EDN: YCMCFV doi: 10.1016/S0140-6736(11)61128-8

[14] Chia S.K., Wolff A.C. With maturity comes confidence: EBCTCG tamoxifen update // Lancet. 2011. Vol. 378, N 9793. P. 747–749. EDN: YCMCFV doi: 10.1016/S0140-6736(11)61128-8

[15] Shagufta, Ahmad I. Tamoxifen a pioneering drug: An update on the therapeutic potential of tamoxifen derivatives. Eur J Med Chem. 2018;143:515–531. EDN: YFEMGL doi: 10.1016/j.ejmech.2017.11.056

[16] Shagufta, Ahmad I. Tamoxifen a pioneering drug: An update on the therapeutic potential of tamoxifen derivatives // Eur J Med Chem. 2018. Vol. 143. P. 515–531. EDN: YFEMGL doi: 10.1016/j.ejmech.2017.11.056

[17] Committee Opinion No. 601: tamoxifen and uterine cancer. Obstet Gynecol. 2014;123(6):1394–1397. doi: 10.1097/01.AOG.0000450757.18294.cf

[18] Committee opinion No. 601: tamoxifen and uterine cancer // Obstet Gynecol. 2014. Vol. 123, N 6. P. 1394–1397. doi: 10.1097/01.AOG.0000450757.18294.cf

[19] Early Breast Cancer Trialists’ Collaborative Group (EBCTCG); Davies C, Godwin J, et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 2011;378(9793):771–784. EDN: UYNKFV doi: 10.1016/S0140-6736(11)60993-8

[20] Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Davies C., Godwin J., et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials // Lancet. 2011. Vol. 378, N 9793. P. 771–784. EDN: UYNKFV doi: 10.1016/S0140-6736(11)60993-8

[21] Ryu KJ, Kim MS, Lee JY, et al. Risk of endometrial polyps, hyperplasia, carcinoma, and uterine cancer after tamoxifen treatment in premenopausal women with breast cancer. JAMA Network Open. 2022;5(11):e2243951. EDN: OWWLIV doi: 10.1001/jamanetworkopen.2022.43951

[22] Ryu K.J., Kim M.S., Lee J., et al. Risk of endometrial polyps, hyperplasia, carcinoma, and uterine cancer after tamoxifen treatment in premenopausal women with breast cancer // JAMA Netw Open. 2022. Vol. 5, N 11. ID: e2243951. EDN: OWWLIV doi: 10.1001/jamanetworkopen.2022.43951

[23] Geiser AG, Hummel CW, Draper MW, et al. A new selective estrogen receptor modulator with potent uterine antagonist activity, agonist activity in bone, and minimal ovarian stimulation. Endocrinology. 2005;146(10):4524–4535. doi: 10.1210/en.2005-0024

[24] Geiser A.G., Hummel C.W., Draper M.W., et al. A new selective estrogen receptor modulator with potent uterine antagonist activity, agonist activity in bone, and minimal ovarian stimulation // Endocrinology. 2005. Vol. 146, N 10. P. 4524–4535. doi: 10.1210/en.2005-0024

[25] Hu R, Hilakivi-Clarke L, Clarke R. Molecular mechanisms of tamoxifen-associated endometrial cancer. Oncology letters. 2015;9(4);1495–1501. doi: 10.3892/ol.2015.2962

[26] Hu R., Hilakivi-Clarke L., Clarke R. Molecular mechanisms of tamoxifen-associated endometrial cancer // Oncology Letters. 2015. Vol. 9, N 4. P. 1495–1501. doi: 10.3892/ol.2015.2962

[27] Smith RA, Manassaram-Baptiste D, Brooks D, et al. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening. CA Cancer J Clin. 2015;65(1):30–54. doi: 10.3322/caac.21261

[28] Smith R.A., Manassaram-Baptiste D., Brooks D., et al. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening // CA Cancer J Clin. 2015. Vol. 65, N 1. P. 30–54. doi: 10.3322/caac.21261

[29] Goldstein SR. Controversy about uterine effects and safety of SERMs: the saga continues. Menopause. 2002;9(5):381–384.

[30] Goldstein S.R. Controversy about uterine effects and safety of SERMs: the saga continues // Menopause. 2002. Vol. 9, N 5. P. 381–384.

[31] Chekalova MA, Borisova MI. Features of ultrasound of endometrial pathological conditions in breast cancer patients receiving tamoxifen: a review of literature. Tumors of the female reproductive system. 2020;16(1):37–42. EDN: QRSZZB doi: 10.17650/1994-4098-2020-16-1-37-42

[32] Чекалова М.А., Борисова М.И. Особенности ультразвуковой диагностики патологических состояний эндометрия на фоне приема тамоксифена при раке молочной железы (обзор литературы) // Опухоли женской репродуктивной системы. 2020. Т. 16, № 1. С. 37–42. EDN: QRSZZB doi: 10.17650/1994-4098-2020-16-1-37-42

[33] Protasova AE, Solntseva IA, Tsypurdeyeva AA, et al. Substantiated approaches to the diagnosis and treatment of tamoxifen-induced endometrial conditions in patients with breast cancer. Journal of Obstetrics and Women’s Diseases. 2018;67(6):69–78. EDN: YVNRPF doi: 10.17816/JOWD67669-78

[34] Протасова А.Э., Солнцева И.А., Цыпурдеева А.А., и др. Обоснованные подходы к диагностике и лечению тамоксифен-индуцированных состояний эндометрия у больных раком молочной железы // Журнал акушерства и женских болезней. 2018. Т. 67, № 6. С. 69–78. EDN: YVNRPF doi: 10.17816/JOWD67669-78

[35] Buijs C, Willemse PH, De Vries EGE, et al. Effect of tamoxifen on the endometrium and the menstrual cycle of premenopausal breast cancer patients. Int J Gynecol Cancer. 2009;19(4). doi: 10.1111/IGC.0b013e3181a47cbe

[36] Buijs C., Willemse P.H., De Vries E.G.E., et al. Effect of tamoxifen on the endometrium and the menstrual cycle of premenopausal breast cancer patients // Int J Gynecol Cancer. 2009. Vol. 19, N 4. doi: 10.1111/IGC.0b013e3181a47cbe

[37] Cheng WF, Lin HH, Torng PL, et al. Comparison of endometrial changes among symptomatic tamoxifen-treated and nontreated premenopausal and postmenopausal breast cancer patients. Gynecol Oncol. 1997;66(2):233–237. doi: 10.1006/gyno.1997.4739

[38] Cheng W.F., Lin H.H., Torng P.L., et al. Comparison of endometrial changes among symptomatic tamoxifen-treated and nontreated premenopausal and postmenopausal breast cancer patients // Gynecol Oncol. 1997. Vol. 66, N 2. P. 233–237. doi: 10.1006/gyno.1997.4739

[39] Runowicz CD, Costantino JP, Wickerham DL, et al. Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR). Am J Obstet Gynecol. 2011;205(6): 535.e1–535.e5. doi: 10.1016/j.ajog.2011.06.067

[40] Runowicz C.D., Costantino J.P., Wickerham D.L., et al. Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR) // Am J Obstet Gynecol. 2011. Vol. 205, N 6. P. 535.e1–535.e5. doi: 10.1016/j.ajog.2011.06.067

[41] Sunderland MC, Osborne CK. Tamoxifen in premenopausal patients with metastatic breast cancer: a review. J Clin Oncol. 1991;9(7):1283–1297. doi: 10.1200/JCO.1991.9.7.1283

[42] Sunderland M.C., Osborne C.K. Tamoxifen in premenopausal patients with metastatic breast cancer: a review // J Clin Oncol. 1991. Vol. 9, N 7. P. 1283–1297. doi: 10.1200/JCO.1991.9.7.1283

[43] Cohen I, Altaras MM, Shapira J, et al. Time-dependent effect of tamoxifen therapy on endometrial pathology in asymptomatic postmenopausal breast cancer patients. I Int J Gynecol Pathol. 1996;15(2):152–157. doi: 10.1097/00004347-199604000-00010

[44] Cohen I., Altaras M.M., Shapira J., et al. Time-dependent effect of tamoxifen therapy on endometrial pathology in asymptomatic postmenopausal breast cancer patients // Int J Gynecol Pathol. 1996. Vol. 15, N 2. P. 152–157. doi: 10.1097/00004347-199604000-00010

[45] Melnikova NS, Kozlova OV, Larionov OV. Ultrasonic, hysteroscopic and histological evaluation of the endometrium in women receiving tamoxifen for breast cancer. Tumors of the female reproductive system. 2013;(3–4):97–100. EDN: RULYIJ doi: 10.17650/1994-4098-2013-0-3-4-97-100

[46] Мельникова Н.С., Козлова О.В., Ларионов О.В. Ультразвуковая, гистероскопическая и гистологическая оценка эндометрия у женщин, получающих тамоксифен по поводу рака молочной железы // Опухоли женской репродуктивной системы. 2013. № 3–4. С. 97–100. EDN: RULYIJ doi: 10.17650/1994-4098-2013-0-3-4-97-100

[47] Neven P, Froyman W, Timmerman S, Timmerman D. Uterine ultrasound and endometrial biopsy in tamoxifen users. Breast Cancer Res Treat. 2020;180:833-834. EDN: LIESGN doi: 10.1007/s10549-020-05595-5

[48] Neven P., Froyman W., Timmerman S., et al. Uterine ultrasound and endometrial biopsy in tamoxifen users // Breast Cancer Res Treat. 2020. Vol. 180. P. 833–834. EDN: LIESGN doi: 10.1007/s10549-020-05595-5

[49] Lin WH, Chang CL. Ultrasonic presentation variation of patients with pathological evidence of endometrial atrophy. Taiwan J Obstet Gynecol. 2023;62(5):719–723. EDN: IFSRPM doi: 10.1016/j.tjog.2023.07.014

[50] Lin W.H., Chang C.L. Ultrasonic presentation variation of patients with pathological evidence of endometrial atrophy // Taiwan J Obstet Gynecol. 2023. Vol. 62, N 5. P. 719–723. EDN: IFSRPM doi: 10.1016/j.tjog.2023.07.014

[51] Sadro CT. Imaging the endometrium: a pictorial essay. Canad Assoc Radiol J. 2016;67(3):254–262. doi: 10.1016/j.carj.2015.09.012

[52] Sadro C.T. Imaging the endometrium: a pictorial essay // Canad Assoc Radiol J. 2016. Vol. 67, N 3. P. 254–262. doi: 10.1016/j.carj.2015.09.012

[53] Jo HB, Lee HJ, Kim SC, et al. Evaluation of endometrial thickness in breast cancer patients with tamoxifen treatment–difference between 2-dimensional ultrasonography and elastosonography. Taiwan J Obstet Gynecol. 2023;62(4):547–552. EDN: DKGRUB doi: 10.1016/j.tjog.2023.04.004

[54] Jo H.B., Lee H.J., Kim S.C., et al. Evaluation of endometrial thickness in breast cancer patients with tamoxifen treatment–difference between 2-dimensional ultrasonography and elastosonography // Taiwan J Obstet Gynecol. 2023. Vol. 62, N 4. P. 547–552. EDN: DKGRUB doi: 10.1016/j.tjog.2023.04.004

[55] Colombo N, Creutzberg C, Amant F, et al. ESMO-ESGO-ESTRO consensus conference on endometrial cancer: diagnosis, treatment and follow-up. Int J Gynecol Cancer. 2016;26(1). EDN: WSRAKH doi: 10.1097/IGC.0000000000000609

[56] Colombo N., Creutzberg C., Amant F., et al. ESMO-ESGO-ESTRO consensus conference on endometrial cancer: diagnosis, treatment and follow-up // Int J Gynecol Cancer. 2016. Vol. 26, N 1. EDN: WSRAKH doi: 10.1097/IGC.0000000000000609

[57] Romero SA, Young K, Hickey M, et al. Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen. Cochrane Database Syst Rev. 2020;12(12):CD007245. EDN: YPIEYT doi: 10.1002/14651858.CD007245.pub4

[58] Romero S.A., Young K., Hickey M., et al. Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen // Cochrane Database Syst Rev. 2020. Vol. 12, N 12. ID: CD007245. EDN: YPIEYT doi: 10.1002/14651858.CD007245.pub4

[59] McGonigle KF, Lantry SA, Odom-Maryon TL, et al. Histopathologic effects of tamoxifen on the uterine epithelium of breast cancer patients: analysis by menopausal status. Cancer letters. 1996;101(1):59–66. doi: 10.1016/0304-3835(96)04114-6

[60] McGonigle K.F., Lantry S.A., Odom-Maryon T.L., et al. Histopathologic effects of tamoxifen on the uterine epithelium of breast cancer patients: analysis by menopausal status // Cancer Letters. 1996. Vol. 101, N 1. P. 59–66. doi: 10.1016/0304-3835(96)04114-6

[61] Fadl SA, Sabry AS, Hippe DS, et al. Diagnosing polyps on transvaginal sonography: is sonohysterography always necessary? Ultrasound Q. 2018;34(4):272–277. doi: 10.1097/RUQ.0000000000000384

[62] Fadl S.A., Sabry A.S., Hippe D.S., et al. Diagnosing polyps on transvaginal sonography: is sonohysterography always necessary? // Ultrasound Quarterly. 2018. Vol. 34, N 4. P. 272–277. doi: 10.1097/RUQ.0000000000000384

[63] Sarkisov CE, Mamikonian IO, Pavlovich SB, et al. Electrosurgical bi- and monopolar destruction of the endometrium in the prevention of relapses of tamoxifen-associated endometrial pathology in postmenopause. Obstetrics and gynecology. 2018;(5):78–84. EDN: OSYOOP doi: 10.18565/aig.2018.5.78-84

[64] Саркисов С.Э., Мамиконян И.О., Павлович С.В., и др. Электрохирургическая бии монополярная деструкция эндометрия в профилактике рецидивов тамоксифенассоцированной патологии эндометрия в постменопаузе // Акушерство и гинекология. 2018. № 5. С. 78–84. EDN: OSYOOP doi: 10.18565/aig.2018.5.78-84

[65] Vilos GA, Alzawawi N, Oraif A, et al. Hysteroscopic endometrial resection in women treated with tamoxifen for breast cancer provides definitive diagnosis and effective long-term therapy. J Obstet Gynaecol Can. 2022;44(5):517–520. EDN: JNXXHH doi: 10.1016/j.jogc.2021.12.007

[66] Vilos G.A., Alzawawi N., Oraif A., et al. Hysteroscopic endometrial resection in women treated with tamoxifen for breast cancer provides definitive diagnosis and effective long-term therapy // J Obstet Gynaecol Can. 2022. Vol. 44, N 5. P. 517–520. EDN: JNXXHH doi: 10.1016/j.jogc.2021.12.007

[67] Bekliere M, Charles A, Galant C, Donnez J. Uterine side effects of tamoxifen: a need for systematic pretreatment screening. Obstet Gynecol. 1998;91(1):40–44. EDN: WOJJAL doi: 10.1016/s0029-7844(97)00591-7

[68] Bekliere M., Charles A., Galant C., et al. Uterine side effects of tamoxifen: a need for systematic pretreatment screening // Obstet Gynecol. 1998. Vol. 91, N 1. P. 40–44. EDN: WOJJAL doi: 10.1016/s0029-7844(97)00591-7

[69] Ivashina SV, Babaeva NA, Motskobili TA, et al. Endometrial atrophy or hyperplasia? Patient management tactics against the background of antiestrogen therapy. Onkology. Journal n.a. P.A. Gertsena. 2022;11(2):13–19. EDN: WOJJAL doi: 10.17116/onkolog20221102113

[70] Ивашина С.В., Бабаева Н.А. Моцкобили Т.А., и др. Атрофия или гиперплазия эндометрия? Тактика ведения пациенток на фоне антиэстрогенной терапии // Онкология. Журнал им. П.А. Герцена. 2022. Т. 11, № 2. С. 13–19. doi: 10.17116/onkolog20221102113

[71] Association of Oncologists of Russia, Russian Society of Clinical Oncology, Russian Society of Specialists in the Prevention and Treatment of Tumors of the Reproductive System. Uterine body cancer and uterine sarcomas. Clinical guidelines. Moscow: Ministry of Health of the Russian Federation; 2020. 68 p. (In Russ.) [cited 2023 Jan 20] Available from: https://oncology-association.ru/wp-content/uploads/2021/02/rak-tela-matki-i-sarkomy-matki-2021.pdf

[72] Ассоциация онкологов России, Российское общество клинической онкологии, Российское общество специалистов по профилактике и лечению опухолей репродуктивной системы. Рак тела матки и саркомы матки. Клинические рекомендации. Москва: Министерство здравоохранения Российской Федерации, 2020. 68 с. Режим доступа: https://oncology-association.ru/wp-content/uploads/2021/02/rak-tela-matki-i-sarkomy-matki-2021.pdf. Дата обращения: 20.01.2023.

[73] Rizzuto I, Nicholson R, MacNab WS, et al. Risk factors and sonographic endometrial thickness as predictors of tumour stage and histological subtype of endometrial cancer. Gynecol Oncol Rep. 2019;30:100491. doi: 10.1016/j.gore.2019.100491

[74] Rizzuto I., Nicholson R., MacNab W.S., et al. Risk factors and sonographic endometrial thickness as predictors of tumour stage and histological subtype of endometrial cancer // Gynecol Oncol Rep. 2019. Vol. 30. ID: 100491. doi: 10.1016/j.gore.2019.100491

[75] Vizzotto JrAO, Nicolau S, Lopes GM, et al. Risk factors for the development of endometrial lesions in breast cancer patients using tamoxyphen: a retrospective cohort study. Revista do Colégio Brasileiro de Cirurgiões. 2023;50:e20233442. EDN: YIHSDW doi: 10.1590/0100-6991e-20233442-en

[76] Vizzotto A.O., Nicolau S., Lopes G.M., et al. Risk factors for the development of endometrial lesions in breast cancer patients using tamoxyphen: a retrospective cohort study // Revista do Colégio Brasileiro de Cirurgiões. 2023. Vol. 50. ID: e20233442. EDN: YIHSDW doi: 10.1590/0100-6991e-20233442-en

[77] Chlebowski RT, Schottinger JE, Shi J, et al. Aromatase inhibitors, tamoxifen, and endometrial cancer in breast cancer survivors. Cancer. 2015;121(13):2147–2155. doi: 10.1002/cncr.29332

[78] Chlebowski R.T., Schottinger J.E., Shi J., et al. Aromatase inhibitors, tamoxifen, and endometrial cancer in breast cancer survivors // Cancer. 2015. Vol. 121, N 13. P. 2147–2155. doi: 10.1002/cncr.29332

[79] Chu SC, Hsieh CJ, Wang TF, Hong MK, Chu TY. Younger tamoxifen-treated breast cancer patients also had higher risk of endometrial cancer and the risk could be reduced by sequenced aromatase inhibitor use: a population-based study in Taiwan. Tzu-Chi Med J. 2020;32(2):175–180. EDN: OZXIIK doi: 10.4103/tcmj.tcmj_17_19

[80] Chu S.C., Hsieh C.J., Wang T.F., et al. Younger tamoxifen-treated breast cancer patients also had higher risk of endometrial cancer and the risk could be reduced by sequenced aromatase inhibitor use: a population-based study in Taiwan // Tzu-Chi Med J. 2020. Vol. 32, N 2. P. 175–180. EDN: OZXIIK doi: 10.4103/tcmj.tcmj_17_19

[81] Lee M, Piao J, Jeon MJ. Risk factors associated with endometrial pathology in premenopausal breast cancer patients treated with tamoxifen. Yonsei Med J. 2020;61(4):317. EDN: SOGXKZ doi: 10.3349/ymj.2020.61.4.317

[82] Lee M., Piao J., Jeon M.J. Risk factors associated with endometrial pathology in premenopausal breast cancer patients treated with tamoxifen // Yonsei Med J. 2020. Vol. 61, N 4. P. 317. EDN: SOGXKZ doi: 10.3349/ymj.2020.61.4.317

[83] Choi S, Lee YJ, Jeong JH, et al. Risk of endometrial cancer and frequencies of invasive endometrial procedures in young breast cancer survivors treated with tamoxifen: a nationwide study. Front Oncol. 2021;11:636378. EDN: NCRKYS doi: 10.3389/fonc.2021.636378

[84] Choi S., Lee Y.J., Jeong J.H., et al. Risk of endometrial cancer and frequencies of invasive endometrial procedures in young breast cancer survivors treated with tamoxifen: a nationwide study // Front Oncol. 2021. Vol. 11. ID: 636378. EDN: NCRKYS doi: 10.3389/fonc.2021.636378

[85] Fung MFK, Reid A, Faught W, et al. Prospective longitudinal study of ultrasound screening for endometrial abnormalities in women with breast cancer receiving tamoxifen. Gynecol Oncol. 2003;91(1):154–159. doi: 10.1016/S0090-8258(03)00441-4

[86] Fung M.F.K., Reid A., Faught W., et al. Prospective longitudinal study of ultrasound screening for endometrial abnormalities in women with breast cancer receiving tamoxifen // Gynecol Oncol. 2003. Vol. 91, N 1. P. 154–159. doi: 10.1016/S0090-8258(03)00441-4

[87] Atabekova LA., Vinogradova NM, Sharapova EI, et al. The importance of echography in the complex diagnosis of endometrial hyperplastic processes in a polyclinic. SonoAce-Ultrasound. 2006;14:29–34. (In Russ.)

[88] Атабекова Л.А., Виноградова Н.М., Шарапова Е.И., и др. Значение эхографии в комплексной диагностике гиперпластических процессов эндометрия в условиях поликлиники // SonoAce-Ultrasound. 2006. Т. 14. С. 29–34.

[89] Strizhakov AN, Davydov AI. Hysteroresectoscopy. Moscow: Medicina; 1997. 236 p. (In Russ.)

[90] Стрижаков А.Н., Давыдов А.И. Гистерорезектоскопия. Москва: Медицина, 1997. 236 с.

[91] Barakat RR, Gilewski TA, Almadrones L, et al. Effect of adjuvant tamoxifen on the endometrium in women with breast cancer: a prospective study using office endometrial biopsy. J Сlin Oncol. 2000;18(20):3459–3463. doi: 10.1200/JCO.2000.18.20.3459

[92] Barakat R.R., Gilewski T.A., Almadrones L., et al. Effect of adjuvant tamoxifen on the endometrium in women with breast cancer: a prospective study using office endometrial biopsy // J Сlin Oncol. 2000. Vol. 18, N 20. P. 3459–3463. doi: 10.1200/JCO.2000.18.20.3459

[93] Gerber B, Krause A, Müller H, et al. Effects of adjuvant tamoxifen on the endometrium in postmenopausal women with breast cancer: a prospective long-term study using transvaginal ultrasound. J Clin Oncol. 2000;18(20):3464–3470. EDN: LUACTR doi: 10.1200/JCO.2000.18.20.3464

[94] Gerber B., Krause A., Müller H., et al. Effects of adjuvant tamoxifen on the endometrium in postmenopausal women with breast cancer: a prospective long-term study using transvaginal ultrasound // J Clin Oncol. 2000. Vol. 18, N 20. P. 3464–3470. EDN: LUACTR doi: 10.1200/JCO.2000.18.20.3464

[95] Davis E, Sparzak PB. Abnormal uterine bleeding. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.

[96] Davis E., Sparzak P.B. Abnormal uterine bleeding. В: StatPearls. Treasure Island (FL): StatPearls Publishing, 2023.

[97] Hefler L, Lafleur J, Kickmaier S, et al. Risk of endometrial cancer in asymptomatic postmenopausal patients with thickened endometrium: data from the FAME-Endo study: an observational register study. Arch Gynecol Obstet. 2018;298:813–820. EDN: JVABVB doi: 10.1007/s00404-018-4885-3

[98] Hefler L., Lafleur J., Kickmaier S., et al. Risk of endometrial cancer in asymptomatic postmenopausal patients with thickened endometrium: data from the FAME-Endo study: an observational register study // Arch Gynecol Obstet. 2018. Vol. 298. P. 813–820. EDN: JVABVB doi: 10.1007/s00404-018-4885-3

[99] Smith-Bindman R, Weiss E, Feldstein V. How thick is too thick? When endometrial thickness should prompt biopsy in postmenopausal women without vaginal bleeding. Ultrasound Obstet Gynecol. 2004;24(5):558–565. doi: 10.1002/uog.1704

[100] Smith-Bindman R., Weiss E., Feldstein V. How thick is too thick? When endometrial thickness should prompt biopsy in postmenopausal women without vaginal bleeding // Ultrasound Obstet Gynecol. 2004. Vol. 24, N 5. P. 558–565. doi: 10.1002/uog.1704

RIGHTS & PERMISSIONS

Eсо-Vector