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Tamoxifen Use Increases Endometrial Cancer Risk in Breast Cancer Patients
A DGReview of :"Tamoxifen and toremifene treatment of breast cancer and risk of subsequent endometrial cancer: A population-based case-control study"
International Journal of Cancer
09/02/2002
By Elda Hauschildt
Tamoxifen treatment increases the risk of breast cancer patients developing endometrial cancer, say Finnish researchers.
The odds ratio (OR) for endometrial cancer following tamoxifen therapy in breast cancer patients, adjusted for significant cofactors, is 2.9. It is especially high, at 9.5, after a lag of more than five years in tamoxifen used for palliative treatment of advanced breast cancer.
Investigators from the Finnish Cancer Registry in Helsinki and the University of Tampere note the risk increase is slightly higher in patients who were younger than 55 years at initiation of tamoxifen therapy.
Risk was more pronounced in patients with well-differentiated endometrial cancer than in those with clinical grades 2 or 3 cancers.
They note that the OR related to adjuvant tamoxifen treatment reached its maximum two to five years after therapy initiation.
The researchers conducted a population-based, case-control study using data on 38,000 breast cancer patients listed with the Finnish Cancer Registry. They included all 59 Finnish patients diagnosed with breast cancer since 1980 who subsequently developed endometrial cancer by the end of 1995.
Each of the patients were matched with three case controls from the Finnish registry database and detailed information was collected on patient treatment and potential confounders using hospital records.
Odds ratio for endometrial cancer was calculated in breast cancer patients treated with toremifene.
Three patients receiving toremifene developed endometrial cancer. The OR for endometrial cancer following toremifene use in breast cancer patients was 0.9.
But, the researchers point out, use of toremifene was rare up to the mid-1990s.
International Journal of Cancer, 2002; 100: 337-341
"Tamoxifen and toremifene treatment of breast cancer and risk of subsequent endometrial cancer: A population-based case-control study"
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