A randomised controlled trial of
prophylactic levonorgestrel
intrauterine system in tamoxifen-treated
women.
Chan SS, Tam WH, Yeo W, Yu MM,
Ng DP, Wong AW, Kwan WH, Yuen
PM.
Department of Obstetrics and
Gynaecology, The Chinese
University of Hong Kong, Prince
of Wales Hospital, Shatin, New
Territories, Hong Kong.
symphorosa@cuhk.edu.hk
Objectives:
To study the
prophylactic use of
levonorgestrel intrauterine
system (LNG-IUS) in the
prevention of endometrial
pathology in women having breast
cancer treated with tamoxifen.
Design:
Randomised controlled
trial.
Setting:
A tertiary
teaching hospital. POPULATION:
One hundred and thirteen women
(66 premenopausal/47
postmenopausal) who required
adjuvant tamoxifen for breast
cancer after the completion of
postoperative radiotherapy and
chemotherapy.
Methods:
Women
were randomised to treatment
group (prophylactic LNG-IUS
insertion before the
commencement of tamoxifen) or
control group. Uterine cavity
was examined by outpatient
hysteroscopy and endometrial
biopsy before and at 12 months
after commencement of tamoxifen.
MAIN OUTCOME MEASURES: De novo
endometrial pathology at 1 year
of tamoxifen.
Results:
Women in
the treatment group had a much
lower incidence of endometrial
polyp (1.8 versus 15.5%, P=
0.017) (relative risk: 0.12; 95%
CI: 0.02-0.91) at 12 months.
There was no significant
difference in the incidence of
submucosal fibroid between the
two groups (1.8 versus 3.4%, P=
1.0). LNG-IUS was retained in
95% women in the treatment group
at 1 year.
Conclusion:
LNG-IUS
reduces the occurrence of de
novo endometrial polyp in women
treated with tamoxifen for
breast cancer.
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