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1.
Rev. bras. ginecol. obstet ; 43(3): 185-189, Mar. 2021. tab
Article in English | LILACS | ID: biblio-1251295

ABSTRACT

Abstract Objective The objective of the present study was to analyze the reasons that led to hormone therapies (HTs) regimen changes in women with breast cancer. Methods This was a retrospective cross-sectional study from a single-institution Brazilian cancer center with patient records diagnosed with breast cancer between January 2012 and January 2017. Results From 1,555 women who were in treatment with HT, 213 (13.7%) women had HT switched, either tamoxifen to anastrozole or vice-versa. Most women included in the present study who switched HT were > 50 years old, postmenopausal, Caucasian, and had at least one comorbidity. From the group with therapy change, 'disease progression' was reason of change in 124 (58.2%) cases, and in 65 (30.5%) patients, 'presence of side effects' was the reason. From those women who suffered with side effects, 24 (36.9%) had comorbidities. Conclusion The present study demonstrated a low rate of HT switch of tamoxifen to anastrozole. Among the reasons for changing therapy, the most common was disease progression, which includes cancer recurrence, metastasis or increased tumor. Side effects were second; furthermore, age and comorbidities are risk factors for side effects.


Resumo Objetivo O objetivo do presente estudo foi analisar os motivos que levaram às mudanças no esquema hormonioterápico (HT) em mulheres com câncer de mama. Métodos Estudo transversal retrospectivo realizado no Hospital da Mulher de Campinas e consequente pesquisa de prontuários de mulheres diagnosticados com câncer de mama entre janeiro de 2012 e janeiro de 2017. Resultados De 1.555 mulheres em tratamento com HT, 213 (13,7%) mulheres tiveram HT alterado, tamoxifeno para anastrozol ou vice-versa. A maioria das mulheres incluídas no presente estudo que tiveram mudança de HT tinha > 50 anos, estava na pós-menopausa, era caucasiana e tinha pelo menos uma comorbidade. Os principais motivos de troca de HT foram devido a 'progressão da doença', ocorrendo em 124 (58,2%) casos e a 'presença de efeitos colaterais' (n = 65; 30,5%). Das mulheres que sofreram efeitos colaterais, 24 (36,9%) apresentaram comorbidades. Conclusão O presente estudo demonstrou uma baixa taxa na alteração de tamoxifeno para anastrozol. Entre as razõesmais comuns para alterar a HT estava a progressão da doença, que inclui recorrência do câncer, metástase ou aumento do tumor. Os efeitos colaterais foram a segunda causa e, além disso, a idade e as comorbidades foram fatores de risco para efeitos colaterais.


Subject(s)
Breast Neoplasms/drug therapy , Antineoplastic Agents, Hormonal/therapeutic use , Neoplasm Recurrence, Local/drug therapy , Patient Participation , Tamoxifen/administration & dosage , Tamoxifen/adverse effects , Tamoxifen/therapeutic use , Medical Records , Cross-Sectional Studies , Retrospective Studies , Disease Progression , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Agents, Hormonal/adverse effects , Anastrozole/administration & dosage , Anastrozole/analogs & derivatives , Anastrozole/therapeutic use
3.
Rev. bras. ginecol. obstet ; 42(11): 726-730, Nov. 2020. tab
Article in English | LILACS | ID: biblio-1144176

ABSTRACT

Abstract Objective: The objective of the present study is to observe the frequency and severity of urinary symptoms in women with breast cancer (BC) being treated with oral hormone therapy, associating them to drug adherence. Methods: The participants were interviewed once from June to October 2016. The evaluation of urinary symptoms was performed by two questionnaires: International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB). Adherence was evaluated by the Morisky-Green method. Statistical analysis was performed by the Mann-Whitney test, linear regression, and Spearman correlation. Results: Fifty-eight women were interviewed: 42 treated with tamoxifen and 16 with aromatase inhibitor. Twenty-seven women (46.5%) presented urinary incontinence symptoms and 15 (25.8%) presented stress urinary incontinence (SUI). Fourteen (24.1%) women had symptoms of overactive bladder (OAB). There was no statistical difference in symptoms between both treatments and duration of treatments. Higher scores in the ICIQ-SF questionnaire were associated with low/medium adherence and advanced age. Higher scores in the ICIQ-OAB questionnaire were associated with low/medium adherence. Conclusion: The present study showed a high prevalence of urinary symptoms, such as urinary incontinence and OAB, associated with low/medium adherence and older age in women with BC being treated with oral hormone therapy. Health professionals should be alert to these symptoms since it could influence life quality and adherence to treatment.


Resumo Objetivo: O objetivo do presente estudo foi observar a frequência e a gravidade dos sintomas urinários em mulheres com câncer de mama em uso de terapia hormonal oral, associando estes com a adesão ao tratamento. Métodos: As pacientes foram entrevistadas uma única vez, entre junho e outubro de 2016. A avaliação dos sintomas urinários foi realizada por dois questionários: International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF, na sigla em inglês) e o Questionário Sobre Bexiga Hiperativa (ICIQ-OAB, na sigla em inglês). A adesão foi avaliada pelo método Morisky-Green. A análise estatística foi realizada pelo teste de Mann-Whitney, regressão linear e correlação de Spearman. Resultados: Foram entrevistadas 58 mulheres: 42 tratadas com tamoxifeno e 16 com inibidor de aromatase. Vinte e sete mulheres (46,5%) apresentaram sintomas de incontinência urinária (IU) e 15 (25,8%) apresentaram incontinência urinária por estresse (IUS). Quatorze (24,1%) das mulheres tinham sintomas de bexiga hiperativa. Não houve diferença estatística nos sintomas entre os tratamentos e a duração dos tratamentos. Os escores mais elevados no questionário ICIQ-SF estiveram associados à baixa/média adesão e à idade avançada. Os escores mais elevados no questionário da ICIQ-OAB foram associados à baixa/média adesão. Conclusão: O presente estudo mostrou alta prevalência de sintomas urinários, como IU e bexiga hiperativa, associadas à baixa/média adesão e à idade mais avançada em mulheres com câncer de mama em tratamento com hormonioterapia oral. Os profissionais de saúde devem estar atentos a esses sintomas, pois eles podem influenciar a qualidade de vida e a adesão ao tratamento.


Subject(s)
Humans , Female , Urinary Incontinence/epidemiology , Breast Neoplasms/drug therapy , Urinary Bladder, Overactive/epidemiology , Medication Adherence , Portugal/epidemiology , Tamoxifen/administration & dosage , Tamoxifen/adverse effects , Urinary Incontinence/chemically induced , Cross-Sectional Studies , Interviews as Topic , Administration, Oral , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Agents, Hormonal/adverse effects , Aromatase Inhibitors/administration & dosage , Aromatase Inhibitors/adverse effects , Urinary Bladder, Overactive/chemically induced , Anastrozole/administration & dosage , Anastrozole/adverse effects , Middle Aged
4.
Rev. Méd. Clín. Condes ; 31(3/4): 352-357, mayo.-ago. 2020. graf, tab
Article in Spanish | LILACS | ID: biblio-1223783

ABSTRACT

INTRODUCCIÓN El cáncer de mama es el tipo de cáncer que se diagnostica con mayor frecuencia en mujeres y la segunda causa más común de muerte por cáncer en este género. Dentro de las indicaciones de tratamiento, se encuentran: cirugía, radioterapia, quimioterapia y terapia endocrina. Esta última se basa en el uso de tamoxifeno, cuyo uso de forma prolongada puede producir efectos secundarios como sequedad vaginal, ardor, irritación, picazón, disuria, incontinencia urinaria, entre otros OBJETIVO Caracterizar la incontinencia urinaria en mujeres premenopáusicas con cáncer de mama en tratamiento con tamoxifeno por 5 años en el Instituto Nacional del Cáncer MATERIAL Y MÉTODO Estudio descriptivo de corte transversal. Se incluyeron mujeres diagnosticadas con cáncer de mama inscritas y tratadas en el Instituto Nacional del Cáncer. Se aplicó cuestionario ICIQ ­SF a la población de estudio con el fin de caracterizar la presencia de incontinencia urinaria. Además, se calculó la proporción entre mujeres con incontinencia urinaria y nuliparidad/mujeres con incontinencia urinaria y paridad RESULTADOS Se evaluaron 15 pacientes. 93,33% presentaron incontinencia urinaria. El promedio de edad de mujeres con incontinencia urinaria fue de 51,21 (± 4,74) años. La razón de mujeres con nuliparidad/con paridad fue de 4:15 CONCLUSIÓN 99,33% de las pacientes presentaron incontinencia urinaria. Los resultados entregados en este estudio deben ser considerados como un elemento que contribuya a detectar la magnitud del problema en la población inscrita y tratada en el Instituto Nacional del Cáncer.


BACKGROUND Breast cancer is the type of cancer diagnosed most frequently in women, and the second most common cause of death from cancer in this gender. Within the indications of treatment, they are: surgery, radiotherapy, chemotherapy and endocrine therapy. The last is based on the use of tamoxifen, whose prolonged use can produce side effects such as vaginal dryness, burning, irritation, itching, dysuria, urinary incontinence, among others OBJECTIVE To characterize urinary incontinence in pre-menopausal women with breast cancer treated with tamoxifen for 5 years at the Instituto Nacional del Cáncer MATERIAL AND METHOD Descriptive cross-sectional study. We included women diagnosed with breast cancer enrolled and treated at the Instituto Nacional del Cáncer. The ICIQ -SF questionnaire was applied to the study population to characterize the presence of urinary incontinence. In addition, the proportion between women with urinary incontinence and nulliparity / women with urinary incontinence and parity was calculated RESULTS 93,33% presented urinary incontinence. The average age of women with urinary incontinence was 51,21 (± 4,74) years. The ratio of women with nulliparity / with parity was 4:15 CONCLUSION 99,33% of the patients presented urinary incontinence. The results delivered in this study should be considered as one element that helps to detect the magnitude of this problem in the population registered and treated in the Instituto Nacional del Cáncer. Keywords:


Subject(s)
Humans , Female , Middle Aged , Tamoxifen/adverse effects , Urinary Incontinence/chemically induced , Urinary Incontinence/epidemiology , Breast Neoplasms/drug therapy , Premenopause , Antineoplastic Agents, Hormonal/adverse effects , Parity , Epidemiology, Descriptive , Cross-Sectional Studies , Surveys and Questionnaires
5.
Rev. Hosp. Ital. B. Aires (2004) ; 40(1): 34-38, mar. 2020. tab
Article in Spanish | LILACS | ID: biblio-1102292

ABSTRACT

Las mujeres han sido tratadas por décadas con testosterona intentando aliviar una gran variedad de síntomas con riesgos y beneficios inciertos. En la mayoría de los países, la testosterona se prescribe "off-label", de modo que las mujeres están utilizando compuestos y dosis ideadas para tratamientos en hombres. En este sentido, varias sociedades médicas de distintos continentes adoptaron recientemente por consenso una toma de posición sobre los beneficios y potenciales riesgos de la terapia con testosterona en la mujer, explorar las áreas de incertidumbre e identificar prácticas de prescripción con potencial de causar daño. Las recomendaciones con respecto a los beneficios y riesgos de la terapia con testosterona se basan en los resultados de ensayos clínicos controlados con placebo de al menos 12 semanas de duración. A continuación se comentan las recomendaciones. (AU)


There are currently no clear established indications for testosterone replacement therapy for women. Nonetheless, clinicians have been treating women with testosterone to alleviate a variety of symptoms for decades with uncertainty regarding its benefits and risks. In most countries, testosterone therapy is prescribed off-label, which means that women are using testosterone formulations or compounds approved for men with a modified dose for women. Due to these issues, there was a need for a global Consensus Position Statement on testosterone therapy for women based on the available evidence from placebo randomized controlled trials (RCTs). This Position Statement was developed to inform health care professionals about the benefits and potential risks of testosterone therapy intended for women. The aim of the Consensus was to provide clear guidance as to which women might benefit from testosterone therapy; to identify symptoms, signs, and certain conditions for which the evidence does not support the prescription of testosterone; to explore areas of uncertainty, and to identify any prescribing practices that have the potential to cause harm. (AU)


Subject(s)
Humans , Female , Aged , Testosterone/therapeutic use , Postmenopause/drug effects , Appetite Depressants/adverse effects , Phenytoin/adverse effects , Placebos/administration & dosage , Psychotropic Drugs/adverse effects , Tamoxifen/adverse effects , Testosterone/administration & dosage , Testosterone/analysis , Testosterone/adverse effects , Testosterone/pharmacology , Cardiovascular Agents/adverse effects , Indomethacin/adverse effects , Gonadotropin-Releasing Hormone/adverse effects , Postmenopause/physiology , Controlled Clinical Trials as Topic , Cholinergic Antagonists/adverse effects , Contraceptives, Oral/adverse effects , Sexual Dysfunctions, Psychological/etiology , Sexual Dysfunctions, Psychological/therapy , Danazol/adverse effects , Consensus , Aromatase Inhibitors/adverse effects , Off-Label Use , Factor Xa Inhibitors/adverse effects , Amphetamines/adverse effects , Histamine Antagonists/adverse effects , Androgen Antagonists/adverse effects , Androgens/physiology , Ketoconazole/adverse effects , Narcotics/adverse effects
6.
Säo Paulo med. j ; 138(1): 64-68, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1099380

ABSTRACT

ABSTRACT BACKGROUND: Endometrial polyps are common in postmenopausal women, and the effect of tamoxifen use (a risk factor for endometrial polyps) on their pathogenesis is unclear. OBJECTIVES: To evaluate the expression of hormone receptors and markers for proliferation/apoptosis (Ki-67 and Bcl-2) in endometrial polyps in postmenopausal users and nonusers of tamoxifen. DESIGN AND SETTING: Cross-sectional analytical study in a tertiary-level academic hospital. METHODS: 46 women (14 tamoxifen users and 32 nonusers) with postmenopausal bleeding underwent hysteroscopic resection of endometrial polyps. Polyp samples were immunohistochemically assessed for detection of Ki-67, Bcl-2 and estrogen and progesterone receptors. RESULTS: Analysis on the glandular component of the polyps revealed progesterone receptor expression in the polyps of 96.9% of the nonusers of tamoxifen, and 92.3% of the tamoxifen users (P = 0.499). All polyps in nonusers and 92.3% of those in users were also positive for estrogen receptors (P = 0.295). Ki-67 was expressed in 75% of the polyps in the tamoxifen users and 82.8% of those in the nonusers. All endometrial polyps expressed Bcl-2. CONCLUSIONS: The immunohistochemical analysis on endometrial polyps demonstrated that, although tamoxifen is considered to be a risk factor for endometrial polyps, there were no significant differences in the expression of hormone receptors between users and nonusers of tamoxifen. There were no between-group differences in Ki-67 and Bcl-2 expression, and all patients displayed inhibition of apoptosis by Bcl-2, thus supporting the theory that polyps develop due to inhibition of apoptosis, and not through cell proliferation.


Subject(s)
Humans , Female , Tamoxifen/adverse effects , Postmenopause , Endometrium , Polyps , Case-Control Studies , Cross-Sectional Studies , Estrogen Antagonists/adverse effects
7.
Rev. chil. obstet. ginecol. (En línea) ; 82(3): 304-306, jun. 2017.
Article in Spanish | LILACS | ID: biblio-899909

ABSTRACT

El tamoxifeno y el letrozol son fármacos muy utilizados en el tratamiento del cáncer de mama. Está descrito que la trombocitopenia (recuento plaquetario inferior a 100.000/mm3) es un efecto secundario raro tras el tratamiento con tamoxifeno. Sin embargo, no es un efecto adverso conocido del letrozol. Presentamos dos casos clínicos en los que tras tratamientos prolongados con estos fármacos nos encontramos con que las pacientes desarrollan trombocitopenia. En ambos casos, este efecto adverso desaparece en pocas semanas tras la retirada del fármaco.


Letrozole and tamoxifen are drugs used in the treatment of breast cancer. It is reported that thrombocytopenia (less than 100,000 / mm3 platelet count) is a rare side effect of tamoxifen. However, it is not a known side effect of letrozole. We present two cases in which after prolonged treatment with these drugs we found that the patients develop thrombocytopenia. In both cases, this adverse effect disappears a few weeks after drugs were stopped.


Subject(s)
Humans , Female , Middle Aged , Tamoxifen/adverse effects , Thrombocytopenia/chemically induced , Breast Neoplasms/drug therapy , Letrozole/adverse effects , Antineoplastic Agents/adverse effects
10.
Article in English | WPRIM | ID: wpr-21470

ABSTRACT

Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Generally, EH is caused by continuous exposure of estrogen unopposed by progesterone, polycystic ovary syndrome, tamoxifen, or hormone replacement therapy. Since it can progress, or often occur coincidentally with endometrial carcinoma, EH is of clinical importance, and the reversion of hyperplasia to normal endometrium represents the key conservative treatment for prevention of the development of adenocarcinoma. Presently, cyclic progestin or hysterectomy constitutes the major treatment option for EH without or with atypia, respectively. However, clinical trials of hormonal therapies and definitive standard treatments remain to be established for the management of EH. Moreover, therapeutic options for EH patients who wish to preserve fertility are challenging and require nonsurgical management. Therefore, future studies should focus on evaluation of new treatment strategies and novel compounds that could simultaneously target pathways involved in the pathogenesis of estradiol-induced EH. Novel therapeutic agents precisely targeting the inhibition of estrogen receptor, growth factor receptors, and signal transduction pathways are likely to constitute an optimal approach for treatment of EH.


Subject(s)
Antineoplastic Agents, Hormonal/adverse effects , Disease Management , Disease Progression , Endometrial Hyperplasia/classification , Female , Gonadotropin-Releasing Hormone/therapeutic use , Humans , Hysterectomy , Molecular Targeted Therapy/methods , Progesterone Congeners/therapeutic use , Risk Factors , Tamoxifen/adverse effects
11.
Article in English | WPRIM | ID: wpr-66175

ABSTRACT

Breast cancer is the most common type of female cancer. Tamoxifen, a selective estrogen receptor modulator, is widely used to decrease breast cancer recurrence and mortality among patients. However, it also increases the risk of endometrial cancer. This study aimed to assess knowledge and decisional conflict regarding tamoxifen use. Between June and October 2014, breast cancer patients using tamoxifen were consecutively screened and requested to complete a survey including the EQ-5D, Satisfaction with Decision Scale (SWD), Decisional Conflict Scale (DCS), and a self-developed, 15-item questionnaire measuring tamoxifen-related knowledge. The study sample comprised 299 patients. The mean total knowledge score was 63.4 of a possible 100.0 (range, 13.3-93.3). While 73.9% of the participants knew that tamoxifen reduces the risk of breast cancer recurrence, only 57.9% knew that the drug increases endometrial cancer risk. A higher education level (> or =college) was associated with a higher, total knowledge score (beta = 4.291; P = 0.017). A higher knowledge score was associated with a decreased DCS score (beta = -0.366; P < 0.001). A higher SWD score was also associated with decreased decisional conflict (beta = -0.178; P < 0.001). In conclusion, the breast cancer patients with higher levels of tamoxifen-related knowledge showed lower levels of decisional conflict regarding tamoxifen use. Clinicians should provide the exact information about tamoxifen treatment to patients, based on knowledge assessment results, so as to aid patients' decision-making with minimal conflict.


Subject(s)
Adult , Aged , Antineoplastic Agents, Hormonal/adverse effects , Breast Neoplasms/drug therapy , Consent Forms/statistics & numerical data , Decision Making , Endometrial Neoplasms/chemically induced , Female , Health Knowledge, Attitudes, Practice , Health Surveys , Humans , Middle Aged , Patient Education as Topic/statistics & numerical data , Patient Participation/statistics & numerical data , Prevalence , Republic of Korea , Risk Assessment , Tamoxifen/adverse effects
12.
Femina ; 41(1): 5-8, jan-fev. tab
Article in Portuguese | LILACS | ID: lil-694472

ABSTRACT

O câncer de mama é a neoplasia maligna mais frequente em mulheres tanto no Brasil quanto no mundo. A doença é mais comum acima dos 50 anos, coincidindo com a faixa etária de risco para o câncer de endométrio. O tamoxifeno é um modulador seletivo de receptor de estrogênio (SERMs), usadona terapêutica das mulheres portadoras de câncer de mama. Assim como os outros SERMs (raloxifeno,toremifeno,arzoxifeno e lasoxifeno), o tamoxifeno pode atuar como antagonista ou agonista, dependendo do tecido-alvo.Nestas pacientes, o uso destes agonistas seletivos embora apresente maior benefício do que risco para o tratamento do câncer de mama, pode causar efeitos secundários no endométrio, com aumento do risco para doenças malignas. Consensos atuais, porém, não demonstram benefício de nenhum método de rastreio para câncer endometrial de rotina. O que se recomenda, nas pacientes na pré e pós-menopausa com câncer de mama, é o exame ginecológico com intervalo anual e o prosseguimento com propedêutica, através de biópsia do endométrio nas pacientes pós-menopausa que apresentam sangramento vaginal.(AU)


Breast cancer is the most common malignancy in women both in Brazil and in the world. The disease is more common over 50 years, coinciding with the age of risk for endometrial cancer. Tamoxifen is a selective modulator of estrogen receptor (SERMs) used in the treatment of women with breast cancer. Like other SERMs (raloxifene, toremifene, arzoxifeno and lasoxifeno), tamoxifen may act as antagonist or agonist depending on the target tissue. In these patients, although showing greater benefit of what risk for the treatment of the breast cancer, can cause side effects on the endometrium, with increased risk for malignant diseases. Current consensus, however, do not demonstrate any benefit from routine screening method for endometrial cancer. Women with breast cancer should undergo annual gynecologic examinations for premenopausal and postmenopausal patients and further workup by means of biopsy in patients with postmenopausal vaginal bleeding.(AU)


Subject(s)
Humans , Female , Tamoxifen/adverse effects , Tamoxifen/therapeutic use , Breast Neoplasms/drug therapy , Endometrial Neoplasms/prevention & control , Endometrial Neoplasms/diagnostic imaging , Endometrium/physiopathology , Review Literature as Topic , Databases, Bibliographic , Evidence-Based Medicine , Antineoplastic Protocols
13.
Medicina (B.Aires) ; 73(2): 97-103, abr. 2013. ilus, graf, tab
Article in Spanish | LILACS | ID: lil-694747

ABSTRACT

Los objetivos fueron evaluar la prevalencia de afecciones endometriales en pacientes tratadas con tamoxifeno (TAM) y analizar los aspectos epidemiológicos, ecográficos, histeroscópicos e histopatológicos. Desde enero de 1999 a diciembre 2008 se estudiaron 152 pacientes con cáncer de mama tratadas con TAM (20 mg/día), sintomáticas (con sangrado) o asintomáticas, pre y postmenopáusicas, incluidas en forma consecutiva. El diseño fue prospectivo y observacional. Los métodos diagnósticos usados fueron ecografía transvaginal, histeroscopía y biopsia. Las pacientes fueron seguidas durante 5 años con ecografía cada 12 meses e histeroscopia con biopsia en casos que lo justificaran. Edad: 62.76 ± 10.24 años y tiempo de tratamiento: 36.2 ± 19.9 meses. El adenocarcinoma se observó en 3/87 (3.45%) pacientes con factores de riesgo y en 1/65 (1.54%) sin ellos (RA: 1.91, IC 95% 1.88 a 1.94). Las afecciones benignas se hallaron en 148 pacientes (97.37% y los adenocarcinomas en 4 (2.63%),1 en un pólipo de aspecto benigno. Los 4 se observaron en mujeres postmenopáusicas (2 asintomáticas) con grosor endometrial igual o mayor a 16 mm. El riesgo de cáncer fue significativamente mayor en sintomáticas (2.36 versus 0.42 en asintomáticas). Tres adenocarcinomas se detectaron entre 24 y 48 meses del tratamiento. Recomendamos un seguimiento con ecografía transvaginal de las pacientes asintomáticas, resección de los pólipos evaluando factores de riesgo y tiempo de exposición, en especial luego de los 24 meses. Consideramos aceptable un cut-off = 10 mm en el grosor del endometrio en postmenopáusicas asintomáticas para realizar histeroscopía y biopsia.


The objectives were to evaluate prevalence of endometrial disease in patients treated with tamoxifen (TAM) and analyze the epidemiological, sonographic, hysteroscopic and histopathological findings. From January 1999 to December 2008, 152 breast cancer patients treated with TAM (20 mg/day), symptomatic (with bleeding) or asymptomatic, pre- and postmenopausal, were included consecutively in a prospective and observational follow-up study Diagnostic methods were (TV) transvaginal ultrasound, hysteroscopy and curettage biopsy. TV ultrasound was performed every 12 months for 12 to 60 months. The patients´ age were 62.76 years ± 10.24 the TAM-time: 36.24 ± 19. Adenocarcinoma was observed in 3/87 patients (3.45%) with risk factors and in 1/65 (1.54%) without them (RA 1.91, IC 95% 1.88-1.94). We found benign disease in 148 patients (97.37%) and adenocarcinomas in 4 (2.63%), one within a polyp. The 4 adenocarcinomas were detected in postmenopausal women (2 asymptomatic) with endometrial thicknesses equal or greater than 16 mm. The cancer risk was significantly increased in symptomatic (2.36 versus 0.42 in asymptomatic). Three adenocarcinomas were observed between 24 and 48 months of treatment. In conclusion, we suggest an adequate transvaginal ultrasound monitoring of asymptomatic patients treated with TAM, with removal of polyps, because atypia can be present hidden within, considerin risk factors and exposure time. We suggest as an acceptable cut-off = 10 mm in asymptomatic postmenopausal patients.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Adenocarcinoma/drug therapy , Breast Neoplasms/drug therapy , Endometrium/drug effects , Selective Estrogen Receptor Modulators/therapeutic use , Tamoxifen/adverse effects , Uterine Diseases/pathology , Adenocarcinoma/diagnosis , Adenocarcinoma/pathology , Biopsy , Endometrium/pathology , Follow-Up Studies , Hysteroscopy , Postmenopause , Prospective Studies , Polyps/chemically induced , Polyps/diagnosis , Polyps/pathology , Uterine Diseases/chemically induced , Uterine Diseases/diagnosis
14.
Salud(i)ciencia (Impresa) ; 19(4): 355-357, sept. 2012.
Article in Spanish | LILACS | ID: lil-702213

ABSTRACT

Los tratamientos endocrinos del cáncer de mama se asocian con diversas repercusiones sobre la masa ósea. El tamoxifeno se caracteriza por sus mínimos efectos deletéreos; para otras terapias, debería considerarse el uso de fármacos protectores, entre los que se destacan los bisfosfonatos


Subject(s)
Bone Density , Breast Neoplasms/complications , Breast Neoplasms/therapy , Tamoxifen/adverse effects , Tamoxifen/therapeutic use
15.
Rev. enferm. UERJ ; 20(1): 15-20, jan.-mar. 2012. tab, graf
Article in Portuguese | LILACS, BDENF | ID: lil-652589

ABSTRACT

Este estudo teve como objetivo examinar a relação entre Imunoglobulina A salivar e o nível de estresse em mulheres mastectomizadas submetidas a tratamento com Tamoxifeno. Os dados foram obtidos através de entrevista realizada com 55 mulheres, com diagnóstico de câncer de mama que iniciaram o tratamento com tamoxifeno no Hospital Santa Rita de Cássia, no município de Vitória/ES, no período de maio de 2007 a fevereiro de 2008. Para análise estatística de mediana, desvio padrão e teste não paramétrico de Wilcoxon foi utilizado o Social Package Statistical Science.  Os resultados demonstraram que, nas mulheres em uso do Tamoxifeno, há mais de três, meses, e com nível intermediário para estresse, ocorreu redução da secreção de Imunoglobulina A salivar. Conclui-se que o tamoxifeno pode influenciar na redução da resposta imunológica quando na presença de estresse em mulheres com câncer de mama.


This study aimed at examining the relation between salivary immunoglobulin A and the level of stress in women with mastectomy on tamoxifen treatment. Data were obtained through interviews with fifty-five women diagnosed with breast cancer, who received treatment with tamoxifen, at the Hospital Santa Rita, in Vitória, ES, Brazil, from May, 2007 to February, 2008. For statistical analysis of median, standard deviation and Wilcoxon non-parametric test, the Social Package Statistical Science (SPSS) was used. Results showed that women with an intermediate level for stress showed reduction of salivary immunoglobulin A secretion after three months in use with tamoxifen. It appears that tamoxifen can influence so as to reduce the immune response when in the presence of stress in women with breast cancer.


Este estudio tuvo como objetivo examinar la relación entre la inmunoglobulina A salival y el nivel de estrés en mujeres con mastectomias sometidas a tratamiento con Tamoxifeno. Los datos fueron obtenidos a través de entrevistas realizadas con 55 mujeres con diagnóstico de cáncer de mama que iniciaron tratamiento con tamoxifeno en el Hospital Santa Rita de Cassia en el municipio de Vitória/ES - Brasil, en el período de mayo de 2007 a febrero de 2008. Para el análisis estadístico de la mediana, desviación estándar y test no paramétrico de Wilcoxon fue utilizado el Social Package Statistical Science. Los resultados demostraron que las mujeres que hacían uso de Tamoxifeno por mas de tres meses y tenían un nivel intermediario de estrés tuvieron una reducción en la secreción de inmunoglobulina A salival. Se concluye que el tamoxifeno puede influenciar en la reducción de la respuesta inmunológica cuando el estrés está presente en mujeres con cáncer de mama.


Subject(s)
Humans , Female , Oncology Nursing/methods , Stress, Psychological/nursing , Immunoglobulin A, Secretory , Breast Neoplasms/nursing , Breast Neoplasms/therapy , Tamoxifen/adverse effects , Statistical Analysis , Brazil , Clinical Trials as Topic , Nursing Informatics , Mastectomy/adverse effects
17.
Lima; s.n; 2011. 34 p. tab.
Thesis in Spanish | LIPECS, LILACS, LIPECS | ID: lil-758197

ABSTRACT

Las mujeres con cáncer de mama invasor con receptores hormonales positivos reciben terapia adyuvante principalmente con Tamoxifeno, que está asociado a proliferación endometrial, hiperplasia, pólipos y cáncer endometrial. El objetivo del estudio es evaluar retrospectivamente la utilidad de la histeroscopia en la evaluación del engrosamiento endometrial asociado al uso de tamoxifeno en cáncer de mama. De 167 histeroscopias realizadas entre enero y diciembre del 2010 se encontraron 51 casos de mujeres con cáncer de mama que tomaban Tamoxifeno y desarrollaron engrosamiento endometrial, siendo llevadas a histeroscopia. La edad media de la población estudiada fue 50.86±9.09 años, la media del peso fue 65.25±11.66, la media del IMC fue 28.09±4.88 Kg/m2, 78.5 por ciento fueron postmenopáusicas; 15.7 por ciento presentó sangrado genital y el grosor endometrial medio fue 13.16mm. Se encontró mala correlación entre el diagnóstico ecográfico, que catalogó como hiperplasia 90.2 por ciento de los casos, y la patología final (p=0.29); el diagnóstico histeroscópico mas frecuente fue pólipo endometrial (39.2 por ciento) seguido por Hiperplasia (27.5 por ciento) y atrofia (23.5 por ciento), con una correlación con la patologia, estadísticamente significativa (p<0.001). La sensibilidad para el diagnóstico de patología endometrial proliferativa fue alta para ecografía e histeróscopia (96.7 por ciento y 86.9 por ciento, respectivamente) pero la especificidades fueron bajas; 5 por ciento para ecografía y 55 por ciento para histeroscopia. Conclusiones: El grosor endometrial en pacientes con cáncer de mama que toman tamoxifeno no es criterio suficiente para procedimientos diagnósticos adicionales debido a la baja especificidad de la ecografía y la histeroscopia, conllevando a una alta frecuencia de procedimientos invasivos innecesarios...


Subject(s)
Humans , Adult , Female , Middle Aged , Endometrial Hyperplasia , Hysteroscopy , Breast Neoplasms , Tamoxifen/adverse effects , Tamoxifen/therapeutic use , Observational Studies as Topic , Retrospective Studies , Cross-Sectional Studies
18.
New Egyptian Journal of Medicine [The]. 2011; 44 (Supp. 3): 19-22
in English | IMEMR | ID: emr-166091

ABSTRACT

Endometrial polyps are the most common endometrial pathology associated with postmenpausal tamoxifen exposure. Up to 3% of these polyp may show malignant changes. is the endometrial cancer has predisposition or risk factors in postmenpausal tamoxifen receiving breast cancer patients risk factors for endometrial polyps. This is prospective study done at El-Hussien and Sayed Galal University hospitals the data were collected from medical records after the patient consent to be involved in this study we have two groups group I in which the hystrescope reveals the endometrial polyp at 6 months of tamoxifen receiving in postmenopausal breast carcinoma patients. Group II in which the hystrescope reveals nothing each group has 20 patients and follow up for one year. age at menopause was significantly older, increased duration of breast disease increased body weight, increased endometrial thickness. In group I if these compared by group II. Various factors such as old age at menopause, increased duration of breast disease increased body weight. Thicker endometri urn may contri bute to the prediction of increased risk of development of endometrial polyp in postmenopausal patients with breast carcinoma treated by tamoxifen


Subject(s)
Humans , Female , Postmenopause , Endometrium/pathology , Polyps , Risk Factors , Tamoxifen/adverse effects
19.
Indian J Med Sci ; 2010 May; 64(5) 197-203
Article in English | IMSEAR | ID: sea-145506

ABSTRACT

Objective: Evaluate the characteristics of arthropathy and musculoskeletal pain after chemotherapy in patients with breast cancer. Materials and Methods: In this study, we evaluate the characteristics of 15 patients with joint symptoms after receiving chemotherapy for breast cancer. Demographic information including sex, age, time of rheumatologic findings after starting of chemotherapy, and time of improvement after starting of medication, and laboratory findings detected for each patient. Results: Patients comprised 15 women with mean age 43.4 ± 10.6 years that received classic chemotherapy for breast cancer according to stage of disease including cyclophosphamide, and tamoxifen. Joint symptoms usually began about 6 months after the first session of chemotherapy. Patients had an average of 2 tender joints and 1 hour of morning stiffness. None of patients were positive for anti-nuclear antibody, and just 1 patient was positive for rheumatoid factor. Non-steroidal anti-inflammatory drugs, disease modifying anti-rheumatic drugs (DMARD), corticosteroids, and venlafaxine were prescribed. 5 patients did not show an improvement and were also given low dose oral corticosteroids. Follow-up was available for all patients. 13 patients showed favorable responses, characterized by a significant decrease (more than 50%) in morning stiffness, pain, and tender joint counts after a mean of 3 months' treatment. 9 patients had complete resolution of symptoms and stopped all medications. Conclusion: Chemotherapy-related arthropathy is not rare, and the prognosis is fairly good with early treatment using NSAID, DMARD, and corticosteroids.


Subject(s)
Adult , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Arthralgia/drug therapy , Arthralgia/etiology , Arthritis/drug therapy , Arthritis/etiology , Breast Neoplasms/drug therapy , Cyclophosphamide/adverse effects , Cyclophosphamide/therapeutic use , Female , Humans , Middle Aged , Prognosis , Tamoxifen/adverse effects , Tamoxifen/therapeutic use
20.
Femina ; 38(5)maio 2010.
Article in Portuguese | LILACS | ID: lil-546433

ABSTRACT

Os sintomas vasomotores constituem grande problema para as mulheres com antecedente de câncer de mama, principalmente as usuárias de tamoxifeno e as tratadas com quimioterapia. A terapia estrogênica, combinada com progesterona ou isolada, ainda é considerada o padrão-ouro no tratamento dos fogachos; porém, geralmente é contraindicada nesse grupo de pacientes devido aos seus efeitos adversos. Desse modo, as mulheres têm procurado, cada vez mais, tratamentos não-hormonais. Destacam-se, entre essas alternativas, as terapias comportamentais, os agentes farmacêuticos não-hormonais ou os fitoterápicos. Existe forte evidência a favor da terapia comportamental cognitiva e da atividade física, porém mais pesquisas são necessárias. Os agentes farmacológicos têm mostrado bons resultados, com destaque para os antidepressivos, a gabapentina e a clonidina. As isoflavonas possuem resultados conflitantes na literatura, assim como a Cimicifuga racemosa.


Vasomotor symptoms are a great problem for survivors of breast cancer, mainly tamoxifen users and women treated with chemotherapy. Estrogen therapy, alone or in combination with progesterone, is currently the gold standard for treatment of hot flashes, but it is often contraindicated for this group of patients because of its adverse effects. Thus, women have been looking for non-hormonal treatments. These alternatives include behavior therapies, non-hormonal pharmaceutical agents or phytotherapeutic drugs. There is strong evidence for cognitive therapy and exercise, but more researches are necessary. The pharmaceutical agents have been presenting good results, especially antidepressants, gabapentin and clonidine. Isoflavones and Cimicifuga racemosa have conflictants results in literature.


Subject(s)
Humans , Female , Antidepressive Agents/therapeutic use , Clonidine/therapeutic use , Medication Therapy Management/trends , Phytotherapy , Hot Flashes/therapy , Breast Neoplasms/complications , Breast Neoplasms/drug therapy , Behavior Therapy/methods , Hormone Replacement Therapy/adverse effects , Drug Therapy/adverse effects , Tamoxifen/adverse effects
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