BJOG. 2007 Dec;114(12):1510-5.
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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- 5 What causes cancer?
- 6 Is cancer a hereditary condition?
- 7 How can gynaecological cancer present?
- 8 How can we reduce the risks of the womens' cancers?
Reducing the Risks of Womens' Cancers.
- 9 What are screening tests?
- 10 What are the reactions to a diagnosis of cancer?
- 11 Is there a place for counselling when cancer is diagnosed?
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Endometrial Cancer (Uterus)
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- 22a How can endometrial cancer be prevented?
- 22b How can endometrial cancer be treated?
Cancer of the Ovary.
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The Treatment Of Womens' Cancers
- 32 Can we predict the course of a cancer?
- 33 What treatment options are available for gynaecological cancer?
- Q32.33c What treatment options are available for ovarian cancer?
Cancer of the Vulva, Vagina and Fallopian Tube
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- 14 Is there a place for a holistic approach to cancer?
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- 38 Should I check myself for breast lumps?
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- 41 What happens if a mammogram shows an abnormality?
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- 42a Breast Cancer Treatment - What is available?
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Web sites and Support Groups
- 44 Are there any support groups?
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- 45 Support Groups.
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