A REALISTIC CLINICAL PERSPECTIVE OF TAMOXIFEN AND ENDOMETRIAL CARCINOGENESIS

Tamoxifen has been the endocrine treatment of choice for all stages of breast cancer for nearly a decade. Millions of women are currently re ceiving tamoxifen worldwide, while large-scale randomised trials have been launched aiming to investigate the drug's merit as a preventive a gent. However, there are now concerns about tamoxifen's potential carc inogenicity. The goal of this review is to address these concerns, re- evaluate the available data from laboratory biological models and thos e fi om clinical reports and put the whole issue into perspective. Our focus is the association between tamoxifen and the increased frequenc y of endometrial tumours, while key issues, such as the role of durati on of tamoxifen therapy, are also addressed. Finally, we discuss the v arious monitoring strategies for early detection of endometrial lesion s and pertinent problems most likely to be encountered by clinicians t aking care of patients who are receiving tamoxifen. Copyright (C) 1996 Elsevier Science Ltd