Use of levonorgestrel-releasing intrauterine systems for decreasing the risk of endometrial pathology in women receiving tamoxifen (literature review)
DOI:
https://doi.org/10.22141/oncology.1.1.2018.155379Keywords:
breast cancer, tamoxifen, hormone therapy, endometrial cancer, endometrial hyperplasia, levonorgestrel, intrauterine contraceptives, reviewAbstract
Breast cancer (BC) is the most common malignant tumor among women. It occurs in every eighth woman in developed countries. Most of the tumors are hormone-dependent. Five years of adjuvant therapy with tamoxifen decreases relative risk of relapse of estrogen-positive BC by 41 % and the risk of death — by 34 %. However, non-tumor and tumor endometrial pathology in patients receiving therapy with tamoxifen still a serious medical problem. Some specialists have used levonorgestrel-releasing intrauterine systems (LNG-IUS) in women with BC, who received tamoxifen, aiming to prevent endometrial hyperplasia. The aim of our work is to study, whether LNG-IUS has a positive effect on endometrial pathology in women receiving tamoxifen therapy of BC. Рublications available in PubMed and Cochrane bases from 1990 to 2015 on the use of tamoxifen and its side effects, LNG-IUS and their effects on the endometrium in women receiving breast cancer therapy were analyzed. The use of LNG-IUS for the prevention of tamoxifen-induced hyperplasia/endometrial cancer seems very promising, but requires more extensive researches to establish the clinical efficacy and safety of this method.References
World Health Organization (WHO): Contraceptive prevalence rate (percentage). WHO Statistical Information System (WHOSIS). — 2010.
Межевитинова Е.А. Приемлемость и эффективность современных методов контрацепции у молодых нерожавших женщин: Автореф. дис… на соискание науч. степени канд. мед. наук: спец. 14.00.01 «Акушерство и гинекология» / Е.А. Межевитинова. — К., 2011. — 213 с.
Gaffield M.E. Medical eligibility criteria for new contraceptive methods: combined hormonal patch, combined hormonal vaginal ring and the etonogestrel implant / M.E. Gaffield, K.M. Curtis, A.P. Mohllajee // Contraception. — 2006 Feb. — 73(2). — P. 134-144.
Suvisaari J. Detailed analysis of menstrual bleeding patterns after postmenstrual and postabortal insertion of a copper IUD or a levonorgestrel-releasing intrauterine system / J. Suvisaari, P. Lahteenmaki // Contraception. — 1996 Oct. — 54(4). — P. 201-208.
Kaunitz A.M. Levonorgestrel-releasing intrauterine system or medroxyprogesterone for heavy menstrual bleeding: a randomized controlled trial / A.M. Kaunitz, F. Bissonnette, I. Monteiro // Obstetrics & Gynecology. — 2010. — Vol. 116(3). — P. 625-632.
Schering A.G. Incidence of complications requiring hospital treatment in LNG IUS users and a control group in 1999-2000. Clinical Study Report AZ32.
Xiao B.L. Pharmacokinetic and pharmacodynamic studies of levonorgestrel-releasing intrauterine device / B.L. Xiao, L.Y. Zhou, X.L. Zhang // Contraception. — 1990. — Vol. 41(4). — P. 353-362.
Varma R. The effectiveness of a levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of endometrial hyperplasia: a long-term follow-up study / R. Varma, H. Soneja, K. Bhatia // Eur. J. Obstet. Gynecol. Reprod. Biol. — 2008. — Vol. 139. — P. 169-175.
American Cancer Society. www.cancer.org.
Early Breast Cancer Trialists Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials // Lancet. — 2005. — Vol. 365(9472). — P. 1687-1717.
Davies C. Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) Collaborative Group. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial / C. Davies, H. Pan, J. Godwin // Lancet. — 2013. — Vol. 381(9869). — P. 805-816.
Cohen I. Endometrial pathologies associated with postmenopausal tamoxifen treatment / I. Cohen // Gynecologic Oncology. — 2004. — Vol. 94(2). — P. 256-66.
Kedar R.P. Effects of tamoxifen on uterus and ovaries of postmenopausal women in a randomized breast cancer prevention trial / R.P. Kedar, T.H. Bourne, T.J. Powles // Lancet. — 1994. — Vol. 343. — P. 1318-1321.
Van Leeuwen F.E. Risk of endometrial cancer after tamoxifen treatment of breast cancer / F.E. Van Leeuwen, J. Benraadt, J.W. Coesbergh // Lancet. — 1994. — Vol. 343. — P. 1318-1321.
ACOG Committee Opinion No 336. Tamoxifen and uterine cancer // Obstetrics and Gynecology. — 2006. — Vol. 107(6). — P. 1475-1478.
Wildemeersch D. Treatment of nonatypical and atypicalendometrial hyperplasia with a levonorgestrel-releasing intrauterinesystem / D. Wildemeersch, M. Dhont // Am. J. Obstet. Gynecol. — 2003. — Vol. 188. — P. 1297-1298.
Backman T. Use of the levonorgestrel-releasing intrauterine system and breast cancer / T. Backman, I. Rauramo, K. Jaakkola // Obstet. Gynecol. — 2005. — Vol. 106. — P. 813-817.
Trinh X.B. Use of the levonorgestrel-releasing intrauterine system in breast cancer patients / X.B. Trinh, W.A. Tjalma, A.P. Makar // Fertil. Steril. — 2008. — Vol. 90. — P. 17-22.
Gardner F.J. Prevention of tamoxifen induced endometrial polyps using a levonorgestrel releasing intrauterine system long-term follow-up of a randomised control trial / F.J. Gardner, J.C. Konje, S.C. Bell // Gynecol. Oncol. — 2009. — Vol. 114. — P. 452-456.
Lyytinen H.K. A cases control study on hormone therapy as a risk factor for breast cancer in Finland / H.K. Lyytinen, T. Dyba, O. Ylikorkala // International Journal of Cancer. — 2009. — Vol. 126(2). — P. 483-489.
Chan S.S.C. A randomised controlled trial of prophylactic levonorgestrel intrauterine system in tamoxifen treated women / S.S.C. Chan, W.H. Tam, W. Yeo // BJOG. — 2007. — Vol. 114(12). — P. 1510-1515.
Gardner F.J.E. Endometrial protection from tamoxifen-stimulated changes by a levonorgestrel-releasing intrauterine system: a randomised controlled trial / F.J.E. Gardner, J.C. Konje, K.R. Abrams // Lancet. — 2000. — Vol. 356(9243). — P. 1711-1717.
Kesim M.D. Long-term effects of the levonorgestrel-releasing intrauterine system on serum lipids and the endometrium in breast cancer patients taking tamoxifen / M.D. Kesim, Y. Aydin, A. Atis // Climacteric. — 2008. — Vol. 11(3). — P. 252-257.
Omar H. The use of levonorgestrel-releasing intrauterine system in prevention of endometrial pathology in women with breast cancer treated with tamoxifen / H. Omar, W. Elkhayat, M. Aboulkasem // The International Journal of Medicine. — 2010. — Vol. 3(1). — P. 327-330.
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