In a randomized trial conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP), tamoxifen (20 mg daily) was compared with placebo as adjuvant breast CANCER therapy. The RELATIVE risk for endometrial cancer after 5 years of tamoxifen USE was 2.2; this is equivalent to an annual hazard rate of approximately 2 cases per 1000 women. Of note, most women who develop uterine cancer during tamoxifen therapy present with vaginal bleeding, have early-stage disease, and usually (but not always) have well-differentiated tumors.

Furthermore, the benefits of tamoxifen in the adjuvant breast cancer SETTING far outweigh the small risk for uterine cancer. Currently, patients receiving tamoxifen should undergo a routine pelvic examination with prompt evaluation of ABNORMAL vaginal bleeding by endometrial biopsy.

In a randomized trial conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP), tamoxifen (20 mg daily) was compared with placebo as adjuvant breast cancer therapy. The relative risk for endometrial cancer after 5 years of tamoxifen use was 2.2; this is equivalent to an annual hazard rate of approximately 2 cases per 1000 women. Of note, most women who develop uterine cancer during tamoxifen therapy present with vaginal bleeding, have early-stage disease, and usually (but not always) have well-differentiated tumors.

Furthermore, the benefits of tamoxifen in the adjuvant breast cancer setting far outweigh the small risk for uterine cancer. Currently, patients receiving tamoxifen should undergo a routine pelvic examination with prompt evaluation of abnormal vaginal bleeding by endometrial biopsy.