Uterine Fibroid in Breast Cancer Patients receiving Tamoxifen Therapy

Abstract

Uterine Fibroid in Breast Cancer Patients receiving Tamoxifen Therapy Mioma Uteri pada Penderita Kanker Payudara dengan Terapi Tamoksifen Rismawati, Fahriatni, Hasanuddin Department of Obstetrics and Gynecology Faculty of Medicine Universitas Syiah Kuala Dr. Zainoel Abidin General Hospital Banda Aceh Abstract Abstrak Objective: Selective estrogen receptor modulators (SERMs) such as tamoxifen play a role in increasing the risk of developing uterine Fibroid. Tujuan: Selektif estrogen reseptor modulator (SERMs) seperti tamoksifen berperan dalam meningkatkan risiko mengembangkan mioma uteri. Methods: Case report. Case: Mrs. 47 years old, Para 6, presented with chief complaints of vaginal bleeding since a year ago. The patient was diagnosed with breast carcinoma 4 years ago and has had a right mastectomy followed by 6 cycles of chemotherapy which is then continued with tamoxifen treatment for 4 years, USG examination revealed uterine myoma to which we performed bilateral salphingoophorectomy hysterectomy, with anatomic pathology results of a uterine Fibroid and chronic endometritis. Conclusions: Selective estrogen receptor modulators (SERMs) such as tamoxifen exhibit antagonistic reactions in breast tissue which makes it appropriate to be used in the treatment of breast cancer. However, they can also be potentially agonistic on estrogen receptors in the uterus, which can cause the growth of uterine Fibroid. Nevertheless, the benefi ts of adjuvant tamoxifen for breast cancer outweighs its potential for developing uterine Fibroid and endometrial carcinoma, because metastatic breast cancer will always be fatal, whereas uterine myoma and endometrial cancer caused by the effects of tamoxifen can be prevented by regular evaluation and total hysterectomy. Keywords: breast cancer,tamoxifen, uterine fi broid. Metode: Laporan Kasus. Kasus: Ny 47 tahun Para 6, datang dengan keluhan perdarahan dari jalan lahir yang dirasakan ibu selama 1 tahun ini, pasien telah menderita kanker payudara 4 tahun yang lalu dan telah dilakukan mastektomi mammae dextra dilanjutkan kemoterapi 6 siklus kemudian dilanjutkan dengan pengobatan tamoksifen selama 4 tahun ini, dari pemeriksaan USG didapatkan adanya mioma uteri kemudian dilanjutkan dengan tindakan histerektomi salphingooforektomi bilateral, dengan hasil patologi anatomi suatu mioma uteri dan endometritis kronis. Kesimpulan: Selektif estrogen reseptor modulator (SERMs) seperti tamoksifen merupakan reaksi antagonis reseptor estrogen pada jaringan payudara yang digunakan dalam pengobatan kanker payudara, tetapi dapat berpotensi agonis

pada reseptor estrogen pada uterus sehingga dapat menyebabkan pertumbuhan mioma uteri. Tetapi penggunaan

tamoksifen ajuvan untuk kanker payudara lebih bermanfaat

dibandingkan dengan potensinya untuk mengembangkan

mioma uteri dan karsinoma endometrium, karena kanker

payudara metastatik akan selalu berakibat fatal, sedangkan

mioma uteri dan kanker endometrium yang ditimbulkan

oleh efek tamoksifen dapat dicegah dengan evaluasi teratur

dan dilakukan tindakan total histerektom. Kata kunci: kanker payudara, mioma uteri, tamoksifen.