Source
Service de chirurgie, centre de lutte contre le cancer (CLCC) Jean-Perrin, Clermont-Ferrand, France.
Abstract
OBJECTIVES:
To review and describe the anatomoclinical cases of the endometrial cancers arising on polyps during a hormonotherapy by tamoxifen for breast cancer.
PATIENTS AND METHODS:
In the surgical inventory 1990-2002 of the benign or malignant uterine lesions investigated by hysteroscopy with dilatation & curettage (D&C) and/or hysterectomy, 108 single or multiple endometrial polyps were encountered and histologically analyzed.
RESULTS:
A malignant transformation of polyp was found in 5 instances, meaning a rate of 4.6% i.e. 5/108: 4 cases of adenocarcinoma, 1 case of sarcoma.
DISCUSSION AND CONCLUSION:
The existence of endometrial polyps - symptomatic or not - does not seem compatible with the prolonged use of tamoxifen treatment owing the estrogen agonist potential effects of tamoxifen and its well-known hyperplastic and carcinogenic properties for the endometrium. The increased risk of endometrial cancer developing in polyps in this iatrogenic context is estimated between 2.5% and 10% in the literature.