© 1991 by Oxford University Press
Journal of the National Cancer Institute, Vol. 83, No. 20, 1488-1491,
October 16, 1991
© 1991 Oxford University Press
Alteration of Endocrine Parameters in Premenopausal Women With Breast Cancer During Long-Term Adjuvant Therapy With Tamoxifen as the Single Agent
Department of Human Oncology, University of Wisconsin Comprehensive Cancer Center Madison, Wis.
*Correspondence to: V. C. Jordan, Ph.D., D.Sc., Department of Human Oncology, University of Wisconsin Comprehensive Cancer Center, 600 Highland Ave., Madison, WI 53792.
Tamoxifen is used to treat selected patients at each stage of breast cancer. Although most clinical experience has been obtained with postmenopausal women, increasing numbers of premenopausal women will be treated with 5 or more years of adjuvant tamoxifen therapy following surgery. Indeed, the proposed use of tamoxifen to prevent breast cancer in high-risk women could result in its extended use during the childbearing years. We have monitored the changes in circulating hormone levels from the ovary and pituitary gland in premenopausal (41–47 years old) women with stage I or II breast cancer during adjuvant therapy with tamoxifen as the single agent for 4–72 months following a mastectomy. Each patient (total eight) continued to menstruate, and ovulation occurred. Circulating levels of luteinizing hormone and follicle-stimulating hormone (except in one woman) remained in the normal range (determined in 12 regularly menstruating women in a control group). The levels of estradiol, estrone, and progesterone were elevated onefold to threefold. Prolactin levels decreased by 30%–40%, but the levels of sex hormone binding-globulin were unaffected. These data demonstrate that premenopausal women taking tamoxifen are potentially at risk for pregnancy and must be counseled about barrier contraception. Furthermore, the impact of many years of ovarian stimulation by tamoxifen must be evaluated, especially in women with node-negative disease or in healthy women in whom tamoxifen is used to prevent breast cancer. [J Natl Cancer Inst 83: 1488–1491, 1991]
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