TAMOXIFEN AND PROLIFERATION OF VAGINAL AND CERVICAL EPITHELIUM IN POSTMENOPAUSAL WOMEN WITH BREAST-CANCER

Objective: The estrogenic effect of tamoxifen on vaginal and cervical epithelium in postmenopausal women with breast cancer is evaluated. St udy Design: The tamoxifen group consisted of 92 postmenopausal breast cancer patients, the control group I of 30 postmenopausal women with b reast cancer receiving no endocrine therapy and the control group II o f 40 postmenopausal women without primary breast cancer taking no horm ones. We determined the maturation index and the incidence of endocerv ical cell hyperplasia and metaplasia in cervical and vaginal smears. R esults: The maturation index increased under tamoxifen within the firs t 24 months from 0.4011 before taking tamoxifen (n=56) to 0.6039 (n=13 8, P<0.0001). The maturation index in the group treated with tamoxifen was statistically significantly higher (P<0.0001) than in the control groups (control group I: 0.3975, P<0.0001; control group II: 0.4102, P<0.0001). Under therapy with tamoxifen endocervical cell hyperplasia (P=0.00156) and metaplasia (P=0.00123) appeared significantly more oft en. Conclusion: An apparent increase not only of the incidence of endo cervical cell hyperplasia and metaplasia but also of the maturation of the vaginal epithelium caused by the estrogenic effect of tamoxifen c ould be demonstrated. (C) 1998 Elsevier Science Ireland Ltd. All right s reserved.