Medication
Conclusion: The majority of women being treated with tamoxifen were asymptomatic, but 48% of sonograms revealed an endometrial thickness of 8 mm or more. Endometrial polyps, the most common abnormality, were diagnosed in 33% of biopsies performed for endometrial thickness of 8 mm or more.
Procedures
Treatment for endometrial polyps involves decreasing circulating levels of estrogen to help stop their growth or removal of the polyps altogether. Your physician may recommend the following watchful waiting, medication, or surgical removal. Watchful waiting: Small polyps that are asymptomatic might get better on their own.
Self-care
If atypical endometrial hyperplasia develops, appropriate gynecologic management should be instituted, and the use of tamoxifen should be reassessed. Tamoxifen, a nonsteroidal antiestrogen agent, is widely used as adjunctive therapy for women with breast cancer.
How common are endometrial polyps in women with tamoxifen?
Premenopausal women treated with tamoxifen have no known increased risk of uterine cancer and require no additional monitoring beyond routine gynecologic care.
What are the treatment options for endometrial polyps?
Should tamoxifen be reassessed for atypical endometrial hyperplasia?
Does tamoxifen increase the risk of uterine cancer in premenopausal women?
Does tamoxifen cause endometrial polyps?
Tamoxifen is associated with an increased incidence of benign endometrial lesions such as polyps and hyperplasia and a two- to four-fold increased risk of endometrial cancer in postmenopausal patients.
What is the risk of endometrial cancer with tamoxifen?
According to the American Cancer Society, the risk of developing endometrial cancer from tamoxifen is about 1 in 500 — a small risk, but higher than that for women in the general population. Tamoxifen also slightly increases the risk of uterine sarcoma, a cancer that begins in the muscle of the uterine wall.
Can tamoxifen cause endometrial thickening?
Tamoxifen may cause the endometrium to appear thickened, irregular, and cystic. Most patients tend to display a multiplicity of findings.
Can tamoxifen cause endometrial hyperplasia?
Tamoxifen results in a spectrum of uterine abnormalities including benign alterations such as endometrial polyps, endometrial hyperplasia, endometrial cystic atrophy, adenomyosis, and uterine fibroid growth as well as malignant transformation into endometrial carcinoma and uterine sarcoma[4–8].
Can postmenopausal woman take tamoxifen?
Tamoxifen can be used to treat both premenopausal and postmenopausal women.
Why is tamoxifen not used in postmenopausal?
Tamoxifen actions are complex. It acts by competitive antagonism of estrogen at its receptor site. It has beneficial agonistic effects in preventing bone demineralization in postmenopausal women, but a detrimental agonistic effect by increasing the risk of uterine cancer and of thrombo-embolism.
What happens when you stop taking tamoxifen?
Blood clots in your veins or lungs. These can occur for up to 2–3 months after you stop taking tamoxifen. Symptoms can include: sudden chest pain. shortness of breath.
How do you prevent uterine polyps?
Can uterine polyps be prevented? There is no way to prevent uterine polyps. It's important to have regular gynecological checkups. Risk factors such as obesity, high blood pressure, or taking tamoxifen to treat breast cancer may increase the chance of developing polyps.
What are the long term side effects of tamoxifen?
Tamoxifen can have side effects, including hot flashes, fatigue, and an increased risk of blood clots and endometrial cancer. But there was no substantial increase in serious side effects, including endometrial cancer incidence or death, in women who took tamoxifen for the longer period, Gray reported.
Can endometrial hyperplasia go away on its own?
If left undiagnosed and untreated, endometrial hyperplasia will usually not abate on its own. Endometrial hyperplasia is often discovered because of abnormal uterine bleeding either between periods or after menopause.
What percentage of endometrial biopsies are cancerous?
Patients with endometrial specimens that show atypia have about a 25 percent likelihood of progressing to carcinoma, compared with less than 2 percent in patients without atypia.
What are the symptoms of endometrial hyperplasia?
Symptoms of endometrial hyperplasiaMenstrual bleeding that is heavier or longer lasting than usual.Menstrual cycles (amount of time between periods) that are shorter than 21 days.Menstrual bleeding between menstrual periods.Not having a period (pre-menopause).Post-menopause uterine bleeding.
Abstract
Endometrial polyps are overgrowths of endometrial glands that typically protrude into the uterine cavity. Endometrial polyps are benign in nature and affect both reproductive age and postmenopausal women. Although endometrial polyps are relatively common and may be accompanied by abnormally heavy bleeding at menstruation.
Introduction
An endometrial polyp or uterine polyp is an abnormal growth containing glands, stroma and blood vessels projecting from the lining of the uterus (endometrium) that occupies spaces small or large enough to fill the uterine cavity. They are found during both reproductive and postmenopausal phases of life.
Aetiology and pathogenesis
The pathogenesis and natural history of endometrial polyps are not very clear, 10 exact cause of endometrial polyps is unknown, however, there are several theories proposed relating to the aetiology and pathogenesis of these lesions.
Clinical characteristics
Polyp lesions are usually benign; however, a small minority may have atypical or malignant features. For the basic classification system, polyps are categorised as being either present or absent, as defined by one or a combination of ultrasound and hysteroscopic imaging with or without histopathology. 44, 45
Diagnosis
There are several options available for the macroscopic diagnosis of endometrial polyps.
Treatment
Management of endometrial polyps depends on symptoms, risk of malignancy and fertility issues. It can be grouped under conservative surgical, radical surgery and conservative non-surgical. Small asymptomatic polyps may resolve spontaneously, in these cases watchful waiting can be the treatment of choice.
Conservative surgery
Hysteroscopic polypectomy has been recommended to be the optimal treatment for the removal of endometrial polyps. 95 Hysteroscopy polypectomy still remains the gold standard for surgical treatment.
What is endometrial polyp?
Sexual & Reproductive. An endometrial polyp is a usually noncancerous growth attached to the inner wall of the uterus, common for women undergoing or who have completed menopause.
What are some examples of endometrial polyps?
Be suspicious of endometrial polyps if your vaginal bleeding is different from your regular pattern. For example, abnormal patterns of vaginal bleeding include bleeding that is: Lighter or heavier than normal. At an unexpected time.
What percentage of endometrial polyps are malignant?
Cancer: Approximately 5 percent of endometrial polyps are malignant. However, data shows that the incidence of polyps that were malignant was significantly higher in postmenopausal compared with premenopausal women, and higher in women who had symptoms of bleeding than in women who did not.
Why do polyps grow in women?
Polyps are caused by overgrowth of the cells lining the uterus (also known as endometrial cells). These cells are very sensitive to the hormone estrogen and grow as a response to circulating levels of estrogen. Endometrial polyps are relatively common in women who [5]:
Where are endometrial polyps located?
Endometrial polyps are growths or masses that occur in the lining of the inner wall of the uterus and often grow large enough to extend into the uterine cavity. They attach to the uterine wall by a large base (these are called sessile polyps) or a thin stalk (these are called pedunculated polyps). Endometrial polyps can be asymptomatic ...
What is the treatment for small polyps?
Medication: Certain hormonal medications, including progestins and gonadotropin-releasing hormone agonists, may lessen symptoms of the polyp.
Can polyps cause cancer?
Treatment involves careful monitoring, as polyps can sometimes be malignant and lead to cancer or problems with fertility. Removal may be necessary as well as medication. You should speak with your primary care physician or OB/GYN about these symptoms.
How long can you take tamoxifen?
Tamoxifen use may be extended to 10 years based on new data demonstrating additional benefit. Women taking tamoxifen should be informed about the risks of endometrial proliferation, endometrial hyperplasia, endometrial cancer, and uterine sarcomas.
Why is the National Surgical Adjuvant Breast and Bowel Project so difficult to interpret?
The National Surgical Adjuvant Breast and Bowel Project data are difficult to interpret because of the rarity of uterine sarcomas and the fact that the effect of tamoxifen use on the rate of uterine sarcomas was not one of the primary or secondary endpoints in the original reports.
Is tamoxifen used for endometrial hyperplasia?
Tamoxifen, a nonsteroidal antiestrogen agent , is widely used as adjunctive therapy for women with breast cancer. It has been approved by the U.S.
Does tamoxifen cause cancer?
Postmenopausal women taking tamoxifen should be closely monitored for symptoms of endometrial hyperplasia or cancer. Premenopausal women treated with tamoxifen have no known increased risk of uterine cancer and require no additional monitoring beyond routine gynecologic care. Unless the patient has been identified to be at high risk ...
Is tamoxifen safe for women?
Women taking tamoxifen should be informed about the risks of endometrial proliferation, endometrial hyperplasia, endometrial cancer, and uterine sarcomas, and any abnormal vaginal bleeding, bloody vaginal discharge, staining, or spotting should be investigated. Postmenopausal women taking tamoxifen should be closely monitored for symptoms ...
Is tamoxifen an antiestrogen?
The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. ABSTRACT: Tamoxifen, a nonsteroidal antiestrogen agent, is widely used as adjunctive therapy for women with breast cancer, and it has been approved by the U.S. Food and Drug Administration for adjuvant treatment of breast cancer, ...
Does tamoxifen reduce breast cancer risk?
The National Surgical Adjuvant Breast and Bowel Project prevention trial (P-1) data suggest that the risk of both invasive and noninvasive breast cancer is markedly reduced with tamoxifen prophylaxis.