Estrogen and Progesterone Receptors Expression in Endometria of Women Receiving Tamoxifen for Breast Cancer, AHMED L. ABOUL NASR, IBTESSAM M. SAAD EL-DIN, MOSTAFA S. SALEM, GHADA A. ABD EL-MOETY and MOHAMED E. EL-MAHY
Abstract
Objective: To analyze the effects of tamoxifen, taken by breast cancer patients, on proliferation and Estrogen Receptors (ER) and Progesterone Receptors (PR) expression in sympto-matic and asymptomatic postmenopausal and premenopausal endometrium.
Methods: This prospective cross-sectional study included 121 perimenopausal and postmenopausal women who received tamoxifen 20mg/day for at least 1 year as an adjuvant therapy for breast cancer. Patients were divided into symptomatic and asymptomatic based on the presence or absence of uterine bleeding. All women underwent 2DTVS and those having a thickened endometrium underwent hysteroscopy with directed biopsy. All specimens were subjected to histopathological examination and immunohistochemical study for ERs and PRs expression.
Results: A total of 100 women were eligible for analysis, of which 36 (36%) patients were symptomatic and 64 (64%) patients were asymptomatic. Overall endometrial pathologies were encountered in 72.22% of symptomatic group and 50% of asymptomatic group (p:0.031). ERs were positively ex-pressed in 100%, 87%, 78.1%, and 23.8% of endometrial carcinoma group, hyperplasia group, polyp group, and the non-pathological group respectively. PRs were positively expressed in 66.7%, 52.2%, 46.9%, and 42.9% of endometrial carcinoma group, hyperplasia group, polyp group, and the non-pathological group respectively.
Conclusion: Endometrial carcinomas, hyperplastic en-dometrium, and polyps frequently exhibit increased ER levels. Furthermore, the high levels of PR appear to be consistent with the estrogenic effects of tamoxifen.