Clinical Investigation

THE EFFECT OF LEVONORGESTREL INTRAUTERINE SYSTEM ON ENDOMETRIUM IN POSTMENOPAUSAL WOMEN WITH BREAST CANCER ON TAMOXIFEN THERAPY

  • Inci Davas
  • Asuman Sevük
  • Ahmet Varolan
  • Basak Baksu
  • Atif Akyol
  • Ali Yazgan

Turk J Obstet Gynecol 2006;3(2):105-111

OBJECTIVE: To evaluate the effect of levonorgestrel releasing intrauterine device on endometrium in postmenopausal women with breast cancer on tamoxifen therapy. Design: A prospective randomised controlled study Setting: Sisli Etfal Training and Research Hospital, Second Gynecology and Obstetrics Clinic, Istanbul Patients: Thirty-four asymptomatic postmenopausal women, with uteruses, operated for breast cancer, on tamoxifen therapy for at least one year. Interventions: Levonorgestrel intrauterine systems were applied to 17 subjects (study group). Main outcome measures: At 1. 3. 6. and 12. months of study, endometrial thickness and anteroposterior diameter of uterus was measured, and vaginal bleeding was scored as 0,1,2 and 3 when bleeding was respectively as ‘spotting, minimal, mild or heavy’. Endometrial biopsies were repeated at the end. RESULTS: There was no difference between the groups with regard to age, gravity, parity, plasma hormone levels, duration of menopause, time passed till diagnosis of breast cancer and duration of tamoxifen use (p>0.05). For all time intervals, there was no difference in the anteroposterior diameter of uterus and endometrial thickness between the groups. However, in the study group, there was a significant decrease in anteroposterior diameter between 1. and 12. months of study (p CONCLUSION: Levonorgestrel intrauterine system is a new preventive measure against undesirable agonistic effects of tamoxifen on endometrium.

Keywords: endometrium, levonorgestrel releasing intrauterine device, meme kanseri, tamoxifen\r\n