Use of levonorgestrel-releasing intrauterine systems for decreasing the risk of endometrial pathology in women receiving tamoxifen (literature review)


  • O.S. Zotov Bogomolets National Medical University, Kyiv, Ukraine,
  • V.V. Patsko Bogomolets National Medical University, Kyiv, Ukraine,



breast cancer, tamoxifen, hormone therapy, endometrial cancer, endometrial hyperplasia, levonorgestrel, intrauterine contraceptives, review


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.


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