scholarly journals Sonographic Study of Female Pelvic Organs in Breast Cancer Patients Taking Tamoxifen: Clinical Correlation

2020 ◽  
Vol 7 (1) ◽  
pp. 17-23
Author(s):  
Rafia Parveen ◽  
Shaikh Shofiur Rahman ◽  
Taposhi Sarker ◽  
Syed Muhammad Baqui Billah ◽  
Zakir Hossain Habib

Background: As most of breast cancer patients are treated with Tamoxifen, different effects of this drug in patients should be evaluated since no such study is carried out in Bangladesh till date. Objective: The purpose of the present study was to evaluate sonographic changes of female genital organs in breast cancer patients treated with Tamoxifen and to correlate these changes with duration of Tamoxifen treatment and gynecological symptoms. Methodology: This randomized double-blind clinical trial was carried out in Delta Medical College Hospital, Dhaka, Bangladesh from May 2017 to April 2018 for a period of one (1) year. The participants were breast cancer patients which were divided into three groups named as group I patients. The patients of these group were on Tamoxifen therapy. The patients of group II were without Tamoxifen therapy. The patients of group III had completed Tamoxifen therapy. All participants underwent ultrasonography. Results: Patients receiving Tamoxifen therapy had significantly more thickened endometrium compared to other groups (26.6% in group I, 5% in group II and3% in group III). Similarly, abnormal sonographic findings and mean uterine volume were higher in group I compared to other two groups. Endometrial thickness and uterine volume showed significant positive correlation with duration of Tamoxifen therapy (p <0.0001). The endometrial thickness and uterine volume greatly increased after two years of Tamoxifen therapy while it was reverse in group III. Gynecological symptoms had no significant relations with sonographic abnormalities and thickened endometrium. Conclusion: Tamoxifen therapy is associated with increased endometrial thickness, uterine volume and abnormal sonographic findings, compared to patients without Tamoxifen or completing Tamoxifen therapy. Journal of Current and Advance Medical Research 2020;7(1): 17-23

1998 ◽  
Vol 84 (1) ◽  
pp. 21-23 ◽  
Author(s):  
Silvia Cecchini ◽  
Stefano Ciatto ◽  
Rita Bonardi ◽  
Antonia Mazzotta ◽  
Paolo Pacini ◽  
...  

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.


1995 ◽  
Vol 13 (12) ◽  
pp. 2906-2915 ◽  
Author(s):  
C E Leonard ◽  
M E Wood ◽  
B Zhen ◽  
J Rankin ◽  
D A Waitz ◽  
...  

PURPOSE To determine if a delay of irradiation to the intact breast for administration of adjuvant chemotherapy results in increased local recurrence in breast cancer. PATIENTS AND METHODS The records of 262 women with 264 cases of breast cancer were reviewed. Group I contained 105 patients treated with conservative surgery, chemotherapy, and radiotherapy. Group II contained 157 patients (used as a concurrent control) treated with conservative surgery and radiotherapy only. Eighty-nine percent of subjects in group I received all chemotherapy before radiotherapy. Fifty-eight percent of patients received hormone therapy. Seventy-one percent of patients had negative surgical margins, and 74% had negative lymph nodes. For group I, conservative surgery-radiotherapy intervals in months were less than 1 (five, 5%), > or = 1 to less than 3 (10, 9%), > or = 1 to less 6 (48, 46%), and > or = 6 (42, 40%), mean of 5. For group II, the intervals were less than 1 (20, 13%), > or = 1 to less than 3 (123, 79%), > or = 3 to less than 6 (11, 7%), and > or = 6 (two, 1%), mean of 1.5. RESULTS Thirty patients (11.5%) have disease recurrence (19 distant [6%] and 12 local [5%]). There were no significant differences in local recurrence (group I, four [4%]; group II, eight [5%]; difference not significant). There were no significant differences in local recurrence in any surgery-radiotherapy interval within each group. Although we found marginal increases in the percentage of local recurrences in group I patients (with prolonged surgery-radiotherapy intervals) who had positive margins, positive lymph nodes, and tumor size more than 2 cm versus group II (without prolonged surgery-radiotherapy intervals), these results were not significant. CONCLUSION We could not identify any surgery-radiotherapy interval that resulted in increased local recurrence if radiotherapy was delayed for administration of adjuvant chemotherapy in breast cancer patients. Because of the heterogenous population of breast cancer patients, our results also support the need for further study to determine the optimum integration of radiotherapy and chemotherapy in the management of the conservatively treated breast.


Author(s):  
Reema A. Thomas ◽  
Catherin Nisha

Background: Endocrine therapy for breast cancer is directed at reducing oestrogen synthesis or alternatively blocking oestrogen receptors (ER) in tumour-sensitive tumors. Despite side effects, the use of systemic adjuvant therapy after local management of breast cancer substantially improves survival and reduces the risk of relapse. The study objective was to assess the recurrence of breast cancer and the complications seen in breast cancer patients on tamoxifen therapy at a hospital-based cancer registry, Thrissur, Kerala.Methods: After obtaining institutional ethical clearance, included 75 patients of histologically diagnosed breast carcinoma currently on tamoxifen, diagnosed in the year of 2016. Data was obtained from the patient files and by personal intimation.Results: Of the 75 patients on tamoxifen, four (5.33%) patients had history of recurrence. 22.6% of patients on tamoxifen were noted to have increased endometrial thickness. Other side effects noted were weight gain, TIA, bone pain and vaginal discharge.Conclusions: It was found that the recurrence rate at three years for the study population was 5.33%. More studies from developing countries, with larger sample size and clinical trials will give us more accurate information regarding the efficacy of the drug.


2022 ◽  
Vol 8 (1) ◽  
pp. 81-86
Author(s):  
Ashwini Ramji ◽  
Shanmugan C V

Background: To assess role of platelet aggregation in metastatic breast cancer patients.Methods:40 cases (Group I) of metastatic breast cancer patients and equal number of healthy control (Group II) subjects were included. Platelet aggregation studies in vitro using ADP and Thrombin were performed using an optical aggregometer. Detection of platelet aggregation was done by Chrono log series 490 dual and four channel optical aggregometer systems.Results:There were 4 subjects in group I and 12 in group II having ADP <60, 26 subjects in group I and 28 in group II with ADP 61-72 and 10 subjects in group I with ADP >72. Low thrombin <58 was seen in 8 in group II, normal thrombin between 61-72 was seen among 11 in group I and 32 in group II and high thrombin >82 among 29 in group I respectively. Amongst patients with normal platelet count, 14 patients had platelet aggregation with ADP in the normal range and 4 patients had platelet aggregation with ADP in the lower range. In patients with high platelet count, 12 showed aggregation in the normal range, and 10 patients showed aggregation in the higher range which was statistically significant (P< 0.05) (Table III, Graph II).Conclusion: Platelet aggregation has an important part to play in the tumor metastasis of breast cancer patients.


2021 ◽  
Author(s):  
Deniz Kocamaz ◽  
Nahide AYHAN FIDANCIOGLU ◽  
Ramazan Cihad Yılmaz ◽  
Tülin Düger ◽  
Yavuz Yakut

Abstract Background Exercise interventions in order to improve disease-related symptoms and improve quality of life in cancer patients are an approach that has received a lot of attention in recent years. The aim of our study is to investigate the effect of aerobic exercise on cancer recovery and to determine the change of cancer markers before and after treatment. Methods 70 women between 18–65 years were included in this study during chemotherapy. They were part of two groups; aerobic exercise (Group I) and control (Group II) groups. Their demographic features, quality of life and some cancer markers were evaluated. Assessments were done pre-chemotherapy and post-chemotherapy. In aerobic exercise group third a week aerobic exercises on submaximal level applied. A 12-week exercise program was planned, conducted under the supervision of a physiotherapist. Results As a result of this study, the quality of life in the aerobic exercise group was significantly higher in breast cancer patients receiving chemotherapy treatment (p < 0.05). The three most commonly used cancer markers were measured in the blood of women with breast cancer pre and post treatment. In the pre-treatment period, the mean serum levels of CEA, CEA 15 − 3, and CEA 19 − 9 were similar in Group I and Group II (p > 0.05). In terms of post-treatment evaluation results, the women in Group I had a greater decrease in CEA, CEA 15 − 3, and CEA 19.9 values than the women in Group II (p < 0.05). Conclusion Aerobic exercise has a positive effect on physical function, role function, cognitive state and emotional state, which are subtitles of quality of life. It has been determined that the decrease of cancer markers in blood serum is greater with aerobic exercise.


2020 ◽  
Vol 6 (1) ◽  
pp. 23-28
Author(s):  
Evi Fatimah ◽  
Erwan Martanto ◽  
Mohammad Iqbal ◽  
Januar W. Martha ◽  
M. Rizki Akbar

Background: Sympathetic hyperactivity is one of the several factors that influence left ventricular dyssynchrony post anthracycline. Cardiovascular risk factors affect the acceleration of left ventricular dyssynchrony. The purpose of this study is to assess the difference in correlation coefficient between HRV and mechanical dispersion in breast cancer patients with and without cardiovascular risk factors after anthracycline administration.Method: This was a cross sectional study with linear regression analysis conducted at Hasan Sadikin General Hospital Bandung between July-October 2018. Subjects were breast cancer patients who had received 6 cycles of FAS and were divided into 2 groups. Group I was patients with breast cancer who have cardiovascular risk factors and group II was without cardiovascular risk factors. Sympathetic hyperactivity was assessed using HRV baseline frequency with minimum duration of recording and left ventricular dyssynchrony was assessed using MD method by echocardiography.Result: This study involved 66 patients. Group I (n=34, age 50.3±6.3 years) and group II (n=32, age 48.5±9 years). The median of LF/HF ratio was 2.7 ms2 (group I) and 1.9 ms2 (group II). MD value in group I and group II was 52.2±13.6 ms and 45.7±8.8 ms, respectively. The result of linear regression analysis showed positive correlation between the LF/HF ratio and MD in group I (r=0.546, p=0.001) and group II (r=0.423, p=0.016) after adjusting three confounding factors (systolic blood pressure, cumulative dose of Doxorubicin, and age).Conclusion: Correlation coefficient of HRV with mechanical dispersion in post anthracycline breast cancer patients in those with cardiovascular risk factorswas worse compared to those without cardiovascular risk factors but was not statistically significant.


Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 771
Author(s):  
Tessa A. M. Mulder ◽  
Mirjam de With ◽  
Marzia del Re ◽  
Romano Danesi ◽  
Ron H. J. Mathijssen ◽  
...  

Tamoxifen is a major option for adjuvant endocrine treatment in estrogen receptor (ER) positive breast cancer patients. The conversion of the prodrug tamoxifen into the most active metabolite endoxifen is mainly catalyzed by the enzyme cytochrome P450 2D6 (CYP2D6). Genetic variation in the CYP2D6 gene leads to altered enzyme activity, which influences endoxifen formation and thereby potentially therapy outcome. The association between genetically compromised CYP2D6 activity and low endoxifen plasma concentrations is generally accepted, and it was shown that tamoxifen dose increments in compromised patients resulted in higher endoxifen concentrations. However, the correlation between CYP2D6 genotype and clinical outcome is still under debate. This has led to genotype-based tamoxifen dosing recommendations by the Clinical Pharmacogenetic Implementation Consortium (CPIC) in 2018, whereas in 2019, the European Society of Medical Oncology (ESMO) discouraged the use of CYP2D6 genotyping in clinical practice for tamoxifen therapy. This paper describes the latest developments on CYP2D6 genotyping in relation to endoxifen plasma concentrations and tamoxifen-related clinical outcome. Therefore, we focused on Pharmacogenetic publications from 2018 (CPIC publication) to 2021 in order to shed a light on the current status of this debate.


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