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Anastrozol (Ana) versus tamoxifen (Tam) treatment in postmenopausal breast cancer women with tamoxifen treatment and abnormal vaginal bleeding: Results from an open-label randomized trial

2005; Lippincott Williams & Wilkins; Volume: 23; Issue: 16_suppl Linguagem: Inglês

10.1200/jco.2005.23.16_suppl.648

1527-7755

A. Krause, Wolfgang Janni, Toralf Reimer, B. Gerber,

Endometrial and Cervical Cancer Treatments

648 Purpose: To compare the effects of switching from adjuvant Tam treatment to Ana in postmenopausal breast cancer women with abnormal vaginal bleedings during Tam treatment and histologically proven benign endometrial pathology. Patients & Methods: 110 postmenopausal women who had received Tam 20 mg/day (312 months, £48 months) and developed abnormal vaginal bleeding were subjected to hysteroscopy as well as dilation and curettage (D&C). Thereafter they were randomized to continue Tam treatment (n=88) or switch to Ana 1 mg/day (n=83). Patients were monitored for £42 months using transvaginal ultrasound (TVUS) at 6 monthly intervals. Results: At the time of study entry, there was no significant difference between vaginal bleeding, endometrial thickness and histological findings between the two treatment groups. Six months after randomization, the mean endometrial thickness in patients who switched to Ana was significantly reduced compared with those who continued Tam treatment (p<0.0001). This significant difference was sustained throughout the treatment period. There was a significant difference in recurrent vaginal bleeding (Tam: 32%, 17/53 and Ana: 4/57, 7% respectively; p<0.0001). In consequence patients receiving anastrozole required fewer repeat hysteroscopy and D&C compared with those who continued Tam treatment. Repeat hysteroscopy and D&C revealed endometrial atrophy in all four cases in the Ana group and 10 polyps, 6 hyperplasias and one endometrial cancer in the Tam group. The first and second histological findings were consistent in 12 (71%) of the 17 patients assessed (p=0.001). Conclusions: Anastrozole represents an effective treatment for the prevention of repeated endometrial pathology in postmenopausal HR-positive breast cancer patients with Tam-induced abnormal vaginal bleedings. No significant financial relationships to disclose.