Screening by Ultrasonography for Endometrial Carcinoma in Postmenopausal Breast Cancer Patients under Adjuvant Tamoxifen

Abstract.Nishimura N, Hachisuga T, Saito T, Kawarabayashi T. Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients.This study aimed to detail the clinicopathologic features of endometrial carcinomas that developed in Japanese patients receiving adjuvant tamoxifen treatment for breast cancer patients. Ten endometrial carcinomas in tamoxifen-treated breast cancer patients were collected from two medical centers. The endometrial carcinomas included two stage Ia, four stage Ib, two stage Ic and two stage IIIc. Three tumors were Grade 1, six were Grade 2, and one was Grade 3. The tumor was limited to the endometrium in two cases. Myometrial invasion was limited to the inner half of the myometrium in five cases and involved the outer half in three. A mild degree of lymphovascular space invasion was identified in five cases. Deep cervical invasion was recognized in one case. The cell types comprised nine endometrioid adenocarcinomas and one serous carcinoma. Five of eight postmenopausal endometrial carcinomas were associated with polypoid endometrial lesions composed of cystically dilated atrophic and proliferative glands widely separated by fibrotic stroma. Two patients with retroperitoneal lymph node metastases died of endometrial cancer. One patient developed a contralateral breast cancer during tamoxifen treatment. No patient died of breast cancer. We did not demonstrate a higher frequency of either high-grade tumors or unfavorable histologic subtypes in tamoxifen-treated Japanese breast cancer patients.

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Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.2001.011004272.x ◽

2001 ◽

Vol 11 (4) ◽

pp. 272-276 ◽

Cited By ~ 3

Author(s):

N. Nishimura ◽

T. Hachisuga ◽

T. Saito ◽

T. Kawarabayashi

Keyword(s):

Breast Cancer ◽

Endometrial Carcinoma ◽

Cancer Patients ◽

Tamoxifen Treatment ◽

Adjuvant Tamoxifen ◽

Breast Cancer Patients

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Association of the phosphorylation of the estrogen receptor at serine 118 and 167 with prognosis in postmenopausal breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.562 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 562-562

Author(s):

Karin J. Beelen ◽

Mark Opdam ◽

Rutger H.T. Koornstra ◽

Andrew D. Vincent ◽

Jan Baptist Vermorken ◽

...

Keyword(s):

Breast Cancer ◽

Estrogen Receptor ◽

Cancer Patients ◽

Estrogen Therapy ◽

Postmenopausal Breast Cancer ◽

Tamoxifen Treatment ◽

Adjuvant Tamoxifen ◽

Breast Cancer Patients ◽

Premenopausal Breast Cancer ◽

Cox Models

562 Background: The sensitivity of the estrogen receptor (ERα) to anti-estrogen therapy can be affected by phosphorylation events. In premenopausal breast cancer patients, phosphorylation of the ERα at serine 118 (ERαS118-p) is predictive for benefit from adjuvant tamoxifen. Since ERαS118-p represents the common hallmark of different signaling cascades that differ in E2 dependency, the resulting effect on estrogen sensitivity may differ between pre- and postmenopausal patients. Phosphorylation of serine 167 (ERαS167-p) has been associated with favorable disease outcome, but whether ERαS167-p can predict tamoxifen sensitivity is currently unknown. We tested the predictive value of both ERαS118-p and ERαS167-p for benefit from adjuvant tamoxifen in postmenopausal breast cancer patients. Methods: We collected primary tumor blocks from 563 ERα positive (stage I-III) postmenopausal patients who had been randomized between tamoxifen (1 to 3 years) vs. no adjuvant therapy (IKA trial). The median follow-up of patients without a recurrence event was 9.4 years. Immunohistochemistry was performed on a TMA using monoclonal antibodies for ERαS118-p and ERαS167-p. The percentage of positive nuclei was scored and a score of ≥ 10 % was considered as positive. Multivariate Cox models were used to assess hazard ratios (HRs) for recurrence free interval and the interaction between these phosphorylations and tamoxifen treatment. Results: We did not find a significant interaction between either ERαS118-p (p=0.99) or ERαS167-p (p=0.44) and tamoxifen, suggesting that the relative benefit from adjuvant tamoxifen in postmenopausal patients is not dependent on the presence of one of these phosphorylations. Both tamoxifen treated patients as well as control patients had a better prognosis when their tumor was positive for ERαS118-p (adjusted HR 0.60 p=0.02) or ERαS167-p (adjusted HR 0.62, p=0.02) compared to patients whose tumor did not express these ERα phosphorylations. Conclusions: In postmenopausal patients ERαS118-p and ERαS167-p are both associated with better prognosis, but do not predict differential benefit from tamoxifen.

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1405 POSTER DISCUSSION Cyp2C19*2 Polymorphism Predicts Benefit of Adjuvant Tamoxifen in ER Positive Postmenopausal Breast Cancer Patients

European Journal of Cancer ◽

10.1016/s0959-8049(11)70898-x ◽

2011 ◽

Vol 47 ◽

pp. S170-S171

Author(s):

K. Beelen ◽

R. Koornstra ◽

M. Opdam ◽

T. Severson ◽

A. Vincent ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Postmenopausal Breast Cancer ◽

Adjuvant Tamoxifen ◽

Breast Cancer Patients ◽

Er Positive

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Role of Ki67 in predicting response to adjuvant tamoxifen in postmenopausal hormonal positive breast cancer patient

QJM ◽

10.1093/qjmed/hcaa057.005 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

H M Abdelaziz ◽

K Naguib ◽

D Moussa ◽

N Mohammad

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Risk Group ◽

Tumor Biology ◽

Postmenopausal Breast Cancer ◽

University Hospital ◽

Adjuvant Tamoxifen ◽

Breast Cancer Patients ◽

Luminal A ◽

Major Health Problem

Abstract Background Breast cancer (BC) is a major health problem in Egypt and worldwide. Its prognosis depends not only on tumor stage but also on tumor biology. Aim of the Work To correlate the percentage of expression of Ki67 with the clinical outcomes of early hormone-receptor positive for postmenopausal breast cancer patients who are receiving adjuvant tamoxifen Material and Methods we retrospectively reviewed 52 patients treated for non-metastatic postmenopausal breast cancer with adjuvant tamoxifen at Ain-Shams University hospital, Clinical Oncology department between January 2010 and December 2015. Ki67 value and other clinicopathological data were retrieved. Results Out of 52 patients fulfilling research criteria, the age rannged from 45 to 71 years.All patients were stage0-ΙΙΙ. Stage II was the most common represented 38.5 %, while Stage 0 was the least common presents 3.8%. Using a ki67cut-off value of 20, patients were stratified into two risk groups; the low risk group had ki67 <20 % and represented (67.3%) of cases and the high risk group were ≥ 20% and represented 32.7%. The median Ki67 value was 12.00 (IQR 5 – 20).Median DFS was 42.5 months (IQR 31.2 – 57). Median of OS was 49 moths (IQR 34 – 58).Among multiple prognostic factors Stage, luminal A subtype was significantly related to better OS and DFS In our study, there was no difference regarding OS and DFS between low and high ki67 group’s results ρ = 0.308 and ρ = 0.064 respectively. Conclusion Ki67 is not a predictive factor for resistance to adjuvant tamoxifen in post-menopausal female breast cancer patients.

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Risk of Endometrial Cancer in Breast Cancer Patients under Long-Term Adjuvant Treatment with Tamoxifen

Tumori Journal ◽

10.1177/030089169808400104 ◽

1998 ◽

Vol 84 (1) ◽

pp. 21-23 ◽

Cited By ~ 9

Author(s):

Silvia Cecchini ◽

Stefano Ciatto ◽

Rita Bonardi ◽

Antonia Mazzotta ◽

Paolo Pacini ◽

...

Keyword(s):

Breast Cancer ◽

Endometrial Cancer ◽

Cancer Patients ◽

Endometrial Thickness ◽

Postmenopausal Breast Cancer ◽

Cancer Surveillance ◽

Tamoxifen Treatment ◽

Adjuvant Tamoxifen ◽

Breast Cancer Patients

Aims To evaluate the relative risk of endometrial cancer with respect to the expected underlying incidence in breast cancer patients undergoing long-term adjuvant tamoxifen therapy. Methods A total of 1010 postmenopausal breast cancer patients receiving adjuvant tamoxifen and with a first negative endometrial ultrasonography (cutoff for abnormal endometrial thickness >5 mm) were followed by annual transvaginal ultrasonography. Abnormal endometrial thickness prompted an outpatient endometrial biopsy or curettage under anesthesia in the case of cervical stenosis and increasing endometrial thickness. The standardized incidence ratio (SIR) with respect to underlying incidence was determined. Results A total of 1,010 eligible subjects who had been receiving tamoxifen for an average of 51 months were enrolled and followed for a total of 2,361 patient-years between January 1993 and December 1996. Five cases of endometrial cancer were observed in the study period: 1 was detected at screening, and 4 were diagnosed for vaginal bleeding in the interval between screening examinations. SIR was 4.0 (95% confidence interval, 1.39.4) and increased to 4.8 (CI, 1.6-10.5) when the single cancer detected at first screening was considered as incident. Conclusions This study adds evidence to the hypothesis that long-term tamoxifen treatment may be responsible for a relevant increase in the risk of developing endometrial cancer. Surveillance based on endometrial ultrasonography was poorly sensitive, but the favorable stage at diagnosis of screen-detected or interval endometrial cancers does not support a more aggressive screening approach.

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