Tamoksifen kullanan meme kanserli postmenopozal olgularda, kemik mineral ve endometrium kalınlığının değerlendirilmesi

Özet

Amaç: Tamoksifen kullanan postımenopozal meme kanserli olguların, kemik mineral dansiteleri (KMD) ve endometrium kalınlıklarının değerlendirilmesi. Materyal ve Metod: Hastanemiz menopoz polikliniğine 01.01.2001-31.12.2001 tarihleri arasında başvuran postmenopozal meme kanserli ve tamoksifen kullanmakta olan 20 kadın, prospektif olarak değerlendirilmiştir. Hastaların yaşı, ovulasyon süresi, VKİ( Vücut kütle indeksi), KMD( Kemik mineral dansitesi), menopoz tedavisi için aldıkları ilaçlar ve kullanım süreleri, meme kanserinin patolojisi ve operasyon tipi, tamoksifen günlük doz ve kullanım süresi verileri toplanmıştır. KMD si 5mm bulunan olgularda probe küretaj ile endometrial doku örneklemesi yapılarak, sonuçlar kaydedildi. Bulgular: Hastaların yaş ortalaması 54.6, ortalama ovulasyon süresi 32 yıldır. Tüm hastalar multipardır. Olguların 2 si (%IO) cerrahi, 18 i (%90) spontan menopoz olup, ortalama menopoz yaşı 45.S olarak bulunmuştur. 11 hastanın VKİ'i

Abstract

Objective: Evaluation of bone mineral density and endometrial thickness in postmenopausal women under tamoxifen treatment for breast cancer. Material and Method: 20 women with postmenopausal breast cancer and under treatment with tamoxifen consulted to menopause polyclinic of our hospital between the dates 01.01.2001-31.12.2001 have been evaluated prospectively. The data related with the age, duration of ovulation, BMI (Body mass index), BMD (Bone mineral density), drugs taken for the treatment of menopause and period of treatment, pathologic type of breast cancer and type of the operation, daily dosage of tamoxifen and period of treatment have been collected. Calcium and antirezorptive treatment has been applied to the cases in which BMD has been measured as 5mm by transvaginal ultrasonography, and the results were recorded. Results: The average age of the patients was 54.6 and the average duration of ovulation was 32 years. The two of the cases (10%) were surgical where as the other eighteen (90%) were spontaneous, and the average age of menopause was 45.8. The average BMD of all the patients was 1.3. Daily dosage of tamoxifen was 20rng, and the total duration of usage was between 12 36 months for 15 patients and >36 months for 5 patients. For the latter group, the average BMD is 1.0. Excluding four hysterectomized patients, the thickness' of the endometrium have been measured as 5mm or above for ten patients (62.5%) among the remaining 16, endometrium samplings have been carried out and the average duration of tamoxifen usage of this group has been detected as27.4 months. The thickness of endotnetrium has been measured as less than 5 mm for six patients, and the average duration of tamoxifen usage of this group is 36.1 months. None of the patients has been used HRT (Hormone Replacement Treatment). Conclusion: Patients using tamoxifen for more than three years were found to have higher bone mineral densities. No positive correlation was found between tamoxifen use and endometrial thickness.