乳腺癌患者术后服用三苯氧胺导致子宫内膜病变的临床病理分析

目的探讨乳腺癌患者术后服用三苯氧胺（tamoxifen,TAM）引起的子宫内膜病理变化。方法将服用TAM出现阴道不规则出血或B型超声提示子宫内膜异常患者80例分为绝经前组（58例）和绝经后组（22例）。根据服用TAM时间（T）长短,分为T〈2年组40例和T≥2年组40例,进行子宫内膜活检。结果口服TAM易发生子宫内膜病变,且子宫内膜重度不典型增生和子宫内膜癌均发生在绝经后组。乳腺癌患者使用TAM发生子宫内膜病变与服药时间长短并无显著关联。结论乳腺癌患者使用TAM治疗发生子宫内膜病变的风险增加,建议用药前进行妇科评估,包括B超了解子宫内膜厚度,并加强用药期间的随访工作。

Clinical and pathologic analysis of endometrial lesion in breast cancer patients taking tamoxifen

Objective To evaluate the effect of tamoxifen（ TAM） on endometrium in postoperative breast cancer patients treated with TAM. Methods Edometrial biopsies were performed in 80 patients having abnormal vaginal bleeding or abnormal thickness of endometrial by ultrasound in TAM group. TAM group was divided into premenopausal and menopausal group or two groups including T〈 2 years and T≥2 years according to the time with tamoxifen. Results The frequency of endometrial hyperplasia and polyps was higher in TAM group. All the atypical hyperplasia and endometrioid carcinoma cases occurred in menopausal group. The occurrence of endometrial disease had no relations with the duration of taking TAM. Conclusion Risk of endometrial disease in postoperative breast cancer patients treated with TAM will be increased. More attention should be paid to the patients who were treated with TAM for breast cancer,and endometrium should be evaluated by pelvic ultrasound before and during TAM usage.