open access
Tamoxifen in breast cancer in uterine malignant mixed Müllerian tumor and sarcoma—A report of 8 cases and review of the literature
open access
Abstract
Aim
Report the outcome of 8 patients (pts) with breast cancer (BC) treated with Tamoxifen (TAM) that developed malignant mixed Müllerian tumor (MMMT) and rare uterine sarcoma (RUS).
Patients and methods
Retrospective study based on data collected from the department medical records between April 1999 and September 2010 among 583 pts with endometrial cancer, 36 pts with MMMT and RUS histopathology. Among them, 8 pts underwent TAM between 4 and 10 years due to a previous diagnosis of BC; all pts were post-menopausal with regular gynecological surveillance; 6 pts (75%) with abnormal uterine bleeding. The diagnosis of 6 pts (MMMT) and 2 pts (RUS) occurred at median interval of 8 years (range 4–12) after initial BC treatment. Pts underwent surgical treatment and were staged as stage I (3pts), IIIA (3pts) and IIIC (2 pts) (FIGO 1988); followed by whole pelvis irradiation (50[[ce:hsp sp="0.25"/]]Gy) and intracavitary HDR brachytherapy boost (24[[ce:hsp sp="0.25"/]]Gy). Two pts underwent chemotherapy (CT). Overall and disease free survival was calculated by Kaplan Meier method.
Results
With a median follow-up of 47 months (range 17–130), 3 pts remain alive recurrence-free of BC and RUS. Four pts died with distant metastasis within the first follow-up year, without BC. One pt died from non-related cancer cause. No evidence of local recurrence was found in the whole group of pts. At two years, DFS and OS were 40% and 80%, respectively.
Conclusion
As reported in the literature, TAM administration and causal effect on MMMT and RUS in BC pts is still unknown. No reports about outcome from these specific pts were found.
Abstract
Aim
Report the outcome of 8 patients (pts) with breast cancer (BC) treated with Tamoxifen (TAM) that developed malignant mixed Müllerian tumor (MMMT) and rare uterine sarcoma (RUS).
Patients and methods
Retrospective study based on data collected from the department medical records between April 1999 and September 2010 among 583 pts with endometrial cancer, 36 pts with MMMT and RUS histopathology. Among them, 8 pts underwent TAM between 4 and 10 years due to a previous diagnosis of BC; all pts were post-menopausal with regular gynecological surveillance; 6 pts (75%) with abnormal uterine bleeding. The diagnosis of 6 pts (MMMT) and 2 pts (RUS) occurred at median interval of 8 years (range 4–12) after initial BC treatment. Pts underwent surgical treatment and were staged as stage I (3pts), IIIA (3pts) and IIIC (2 pts) (FIGO 1988); followed by whole pelvis irradiation (50[[ce:hsp sp="0.25"/]]Gy) and intracavitary HDR brachytherapy boost (24[[ce:hsp sp="0.25"/]]Gy). Two pts underwent chemotherapy (CT). Overall and disease free survival was calculated by Kaplan Meier method.
Results
With a median follow-up of 47 months (range 17–130), 3 pts remain alive recurrence-free of BC and RUS. Four pts died with distant metastasis within the first follow-up year, without BC. One pt died from non-related cancer cause. No evidence of local recurrence was found in the whole group of pts. At two years, DFS and OS were 40% and 80%, respectively.
Conclusion
As reported in the literature, TAM administration and causal effect on MMMT and RUS in BC pts is still unknown. No reports about outcome from these specific pts were found.
Keywords
Breast cancer; Tamoxifen-related uterine sarcoma; Pelvic irradiation
About this articleTitle
Tamoxifen in breast cancer in uterine malignant mixed Müllerian tumor and sarcoma—A report of 8 cases and review of the literature
Journal
Reports of Practical Oncology and Radiotherapy
Issue
Pages
251-260
Published online
2013-09-01
DOI
10.1016/j.rpor.2013.06.005
Bibliographic record
Rep Pract Oncol Radiother 2013;18(5):251-260.
Keywords
Breast cancer
Tamoxifen-related uterine sarcoma
Pelvic irradiation
Authors
Ana Luisa Vasconcelos
Beatriz Nunes
Catarina Duarte
Vera Mendonça
Joana Ribeiro
Marília Jorge
Isabel Monteiro Grillo