Background: In Sudan, the common endocrine therapy tamoxifen is prescribed to HR-positive
patients, which is associated with a variety of complications such as hot
flashes, vaginal discharge, and vaginal dryness. Objective: This study
aimed to determine the gynecological side effects of tamoxifen among Sudanese
women who have been diagnosed with breast cancer in Khartoum, Sudan. Methods:
A retrospective cross-sectional study was conducted at Alzara Hospital in Al
Amal Toure Revere, Sudan. A convenience sample of individuals previously
diagnosed with breast cancer attended refer clinic. From October 2020 to
September 2021, all patients attending were checked for eligibility. Results:
A total of 100 patients were enrolled in the study; 60% of patients reported
increased vaginal secretions after taking the drug, 28% reported normal vaginal
secretions with no change, and 11% reported decreased secretions after taking
the medication, while 22% developed vaginal bleeding, and 22% of the ultrasound
results revealed endometrial masses among the study patients. Also, 54 percent
of female patients experienced hot flashes after taking the medication, and 12%
of women missed some doses of treatment. Conclusion: Tamoxifen results
in several gynecological side effects in women with breast cancer. A high
percentage of women in the study developed hot flashes, vaginal bleeding, and
discharge, in addition to having ultrasound results showing endometrial masses
among them.
References
[1]
Kumar, V., Abbas, A.K. and Aster, J.C. (2015) Robbins & Cotran Pathologic Basis of Disease. 9th Edition, Elsevier, Philadelphia.
[2]
Ai, D., Yao, J., Yang, F., Huo, L., Chen, H., Lu, W., et al. (2021) TRPS1: A Highly Sensitive and Specific Marker for Breast Carcinoma, Especially for Triple-Negative Breast Cancer. Modern Pathology, 34, 710-719.
https://doi.org/10.1038/s41379-020-00692-8
[3]
Lamb, C.A., Vanzulli, S.I. and Lanari, C. (2019) Hormone Receptors in Breast Cancer: More than Estrogen Receptors. Medicina (B Aires), 79, 540-545.
[4]
Bartlett, J.M.S., Sgroi, D.C., Treuner, K., Zhang, Y., Ahmed, I., Piper, T., et al. (2019) Breast Cancer Index and Prediction of Benefit from Extended Endocrine Therapy in Breast Cancer Patients Treated in the Adjuvant Tamoxifen—To Offer More? (aTTom) Trial. Annals of Oncology, 30, 1776-1783.
https://doi.org/10.1093/annonc/mdz289
[5]
Hale, M.J., Howell, A., Dowsett, M., Cuzick, J. and Sestak, I. (2020) Tamoxifen Related Side Effects and Their Impact on Breast Cancer Incidence: A Retrospective Analysis of the Randomised IBIS-I Trial. Breast, 54, 216-221.
https://doi.org/10.1016/j.breast.2020.10.015
[6]
Garreau, J.R., Delamelena, T., Walts, D., Karamlou, K. and Johnson, N. (2006) Side Effects of Aromatase Inhibitors versus Tamoxifen: The Patients’ Perspective. The American Journal of Surgery, 192, 496-498.
https://doi.org/10.1016/j.amjsurg.2006.06.018
[7]
Meiser, B., Wong, W.K.T., Peate, M., Julian-Reynier, C., Kirk, J. and Mitchell, G. (2017) Motivators and Barriers of Tamoxifen Use as Risk-Reducing Medication amongst Women at Increased Breast Cancer Risk: A Systematic Literature Review. Hereditary Cancer in Clinical Practice volume, 15, Article No. 14.
https://doi.org/10.1186/s13053-017-0075-8
[8]
Rangel-Méndez, J.-A., Rubi-Castellanos, R., Sánchez-Cruz, J.-F. and Moo-Puc, R.E. (2019) Tamoxifen Side Effects: Pharmacogenetic and Clinical Approach in Mexican Mestizos. Translational Cancer Research, 8, 23-34.
https://doi.org/10.21037/tcr.2018.12.27
[9]
Baum, M., Budzar, A.U., Cuzick, J., Forbes, J., Houghton, J.H., Klijn, J.G.M., et al. (2002) Anastrozole Alone or in Combination with Tamoxifen versus Tamoxifen Alone for Adjuvant Treatment of Postmenopausal Women with Early Breast Cancer: First Results of the ATAC Randomised Trial. Lancet, 359, 2131-2139.
https://doi.org/10.1016/S0140-6736(02)09088-8
[10]
Carraway, H. and Wolff, A.C. (2004) Anastrozole Is Safer and May Be More Effective than Tamoxifen in Postmenopausal Women with Early-Stage Breast Cancer. Cancer Treatment Reviews, 30, 303-307. https://doi.org/10.1016/j.ctrv.2004.01.008
[11]
Jeon, S.J., Lee, J.I., Lee, M., Kim, H.S., Kim, J.W., Park, N.H., et al. (2017) Endometrial Polyp Surveillance in Premenopausal Breast Cancer Patients Using Tamoxifen. Obstetrics & Gynecology Science, 60, 26-31.
https://doi.org/10.5468/ogs.2017.60.1.26
[12]
Exacoustos, C., Zupi, E., Cangi, B., Chiaretti, M., Arduini, D. and Romanini, C. (1995) Endometrial Evaluation in Postmenopausal Breast Cancer Patients Receiving Tamoxifen: An Ultrasound, Color Flow Doppler, Hysteroscopic and Histological Study. Ultrasound in Obstetrics & Gynecology, 6, 435-442.
https://doi.org/10.1046/j.1469-0705.1995.06060435.x
[13]
Stearns, V., Ullmer, L., López, J.F., Smith, Y., Isaacs, C. and Hayes, D. (2002) Hot Flushes. Lancet, 360, 1851-1861. https://doi.org/10.1016/S0140-6736(02)11774-0
[14]
Aldaak, M., Suliman, H.M., Abd-Elgadir, E.E. and Abdoon, I.H. (2022) Impact of Anticancer Therapy on the Quality of Life of Sudanese Patients with Breast Cancer at Khartoum Oncology Hospital. BMC Women’s Health, 22, Article No. 448.
https://doi.org/10.1186/s12905-022-02041-0
[15]
Lorizio, W., Wu, A.H.B., Beattie, M.S., Rugo, H., Tchu, S., Kerlikowske, K., et al. (2012) Clinical and Biomarker Predictors of Side Effects from Tamoxifen. Breast Cancer Research and Treatment, 132, 1107-1118.
https://doi.org/10.1007/s10549-011-1893-4
