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目的观察乳腺癌患者服用三苯氧胺后对子宫和卵巢的影响。方法对82例服用三苯氧胺的乳腺癌患者进行了随访,服药后3个月进行妇科检查及盆腔B超检查,以后每6个月复查1次。必要时宫腔镜检查及切除子宫。结果35例(74.5%)绝经妇女服用三苯氧胺后子宫体积明显增大,4例(9%)子宫肌瘤,10例(21.3%)子宫内膜病变包括子宫内膜息肉6例、子宫内膜增生3例、不典型增生1例;26例(74.3%)绝经前妇女服用三苯氧胺后子宫体积明显增大,6例(17.1%)子宫肌瘤,7例(20%)子宫内膜病变包括子宫内膜萎缩1例、子宫内膜腺囊性增生1例、内膜息肉2例、增生期内膜2例、蜕膜化反应1例。10例(21.3%)绝经前妇女服药后出现卵巢囊肿,而绝经后妇女服药后仅2例(4.3%)出现卵巢囊肿。结论乳腺癌患者服用三苯氧胺刺激子宫内膜和平滑肌增殖,对子宫的影响与绝经状态关系不密切。刺激卵巢囊肿产生,而卵巢囊肿的发生率则绝经妇女比绝经前妇女低。多为良性且停药后逐渐消失。
Objective To observe the effect of tamoxifen on uterus and ovary in breast cancer patients. Methods 82 patients with tamoxifen breast cancer were followed up, 3 months after taking gynecological examination and pelvic ultrasound B, every 6 months after a review. If necessary, hysteroscopy and removal of the uterus. Results 35 cases (74.5%) of menopausal women taking tamoxifen significantly increased uterine volume, 4 cases (9%) of uterine fibroids, 10 cases (21.3%) of endometrial lesions including endometrial polyps in 6 cases, endometrial hyperplasia 3 cases and atypical hyperplasia in 1 case. 26 cases (74.3%) of premenopausal women significantly increased uterine volume after taking tamoxifen, 6 cases (17.1%) had uterine fibroids and 7 cases (20%) had endometrial diseases including intrauterine 1 case of atrophy, 1 case of endometrial cystoid hyperplasia, 2 cases of endometrial polyps, 2 cases of proliferative endometrium and 1 case of decidualization. Ovarian cysts were found in 10 (21.3%) premenopausal women and in 2 (4.3%) postmenopausal women with ovarian cysts. Conclusion Patients with breast cancer take tamoxifen to stimulate endometrial and smooth muscle proliferation, the impact on the uterus and the relationship between menopausal status is not close. Stimulate the generation of ovarian cysts, while the incidence of ovarian cysts in postmenopausal women than in pre-menopausal women. Mostly benign and gradually disappear after stopping.