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The effect of adjuvant therapy with or without tamoxifen on the endocrine function of patients with breast cancer

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Abstract

The ovarian and pituitary functions of 64 operable breast cancer patients undergoing adjuvant therapy with cytotoxic chemotherapy and/or tamoxifen were investigated. The post menopausal patients, divided into 3 treatment groups, one with tamoxifen alone, one with tamoxifen and chemotherapy and the other with chemotherapy alone had serum estradiol 17-β (E2) and progesterone levels lower than the evaluable limits. Although there was no significant difference in the level of estrone sulfate (E1-S) between these three groups, the level of lutainizing hormone (LH) and follicle stimulating hormone (FSH) in the patients treated with tamoxifen alone and tamoxifen and chemotherapy were significantly lower than those treated with chemotherapy alone. The decrease in gonadotropin levels induced by tamoxifen treatment was reversible as it appeared after the initiation of tamoxifen and recovered after its cessation. In the premenopausal patients, a group treated with tamoxifen and chemotherapy had significantly higher E1-S, E2 and progesterone levels and significantly lower gonadotropin levels than a group treated with chemotherapy alone or one treated with a cyclophosphamide regimen. These increases in the levels of estrogen and progesterone were also reversible, and induced by tamoxifen. Thus, adjuvant endocrinochemotherapy causes profound alteration in the hypothalamo-pituitary-ovarian axis and therefore, monitoring a variety of hormonal levels is thought to be necessary for assessing the consequences of adjuvant therapy in breast cancer patients, especially in premenopausal patients using tamoxifen.

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References

  1. Fisher B, Redmond C, Brown A, Wolmark N, Wittleff J, Fisher ER, Plotkin D, Bowman D, Sachs S, Wolter J, Frelick R, Desser R, LiCalzi N, Geggie P, Cambell T, Elias EG, Prager D, Kootz P, Volk H, Dimitrov N, Gradner B, Lerner H, Shibata H, and other NSABP investigators. Treatment of primary breast cancer with chemotherapy and tamoxifen. New Engl J Med 1981; 305: 1–6.

    Article  PubMed  CAS  Google Scholar 

  2. Jordan VC. Oestrogen and anti-oestrogen action: A hypothesis for the regulation of breast cancer cell replication. In Cavalli F ed. Endocrine therapy of breast cancer, Concept and Strategie. Berlin: Springer-Verlag. 1986; 41–49.

    Google Scholar 

  3. Furr BJA, Jordan VC. The pharmacology and clinical uses of tamoxifen. Pharmac Ther 1984; 25: 127–250.

    Article  CAS  Google Scholar 

  4. Honjyo H, Kitawaki J, Itoh M, Yasuda J, Urabe M, Naitoh K, Yamamoto T, Okada H. Serum and urine estrone sulfate during the menstrual cycle, measured by a direct radioimmunoassay, and fate of exogeneous injected estrone sulfate. Hormone Res 1987; 27: 61–68.

    Google Scholar 

  5. Honjyo H. Aging of ovary and estrone sulfate. Adv Obstet Gynecol 1987; 4: 483–487.

    Google Scholar 

  6. Rose DP, Davis TE. Ovarian function in patients receiving adjuvant chemotherapy for breast cancer. Lancet 1977; 1: 1174–1176.

    Article  PubMed  CAS  Google Scholar 

  7. Dnistrian AM, Schwartz MK, Fracchia AA, Kaufman RJ, Hakes TB, Carrie VE. Endocrine consequence of CMF adjuvant therapy in premenopausal and postmenopausal breast cancer patients. Cancer 1983; 51: 803–807.

    Article  PubMed  CAS  Google Scholar 

  8. Helgason S, Wilkins N, Carlstrom K, Damber MG. A comparative study of the estrogen effects of tamoxifen and 17β estradiol in postmenopausal women. J Clin Endocrinol Metabol 1982; 54: 404–407.

    Article  CAS  Google Scholar 

  9. Delrio G, DePlacido S, Pegliarulo C, d'Istria M, Fasano S, Marinelli A, Citarella F, DeSio L, Contegiacomo A, Iaffaioli RV, Petrilla G, Ricciardi I, Bianco AR. Hypothalamic-pituitary-ovarian axis in women with operable breast cancer treated with adjuvant CMF and tamoxifen. Tumori 1986; 72: 53–61.

    PubMed  CAS  Google Scholar 

  10. Dnistrian AM, Greenberg EJ, Dillon HJ, Hakes TB, Fracchia AA, Schwartz MK. Chemohormonal therapy and endocrine function in breast cancer patients. Cancer 1985; 56: 63–70.

    Article  PubMed  CAS  Google Scholar 

  11. Koyama N, Wada T, Nishizawa Y, Iwanaga T, Aoki Y, Terazawa T, Kosaki G, Yamamoto T, Wada A. Cyclophosphamide-induced ovarian failure and its-therapeutic significance in patients with breast cancer. Cancer 1977; 39: 1403–1409.

    Article  PubMed  CAS  Google Scholar 

  12. Rose DP, Davis TE. Effects of adjuvant chemohormonal therapy on the ovarian and adrenal function of breast cancer patients. Cancer Res 1980; 40: 4043–4047.

    PubMed  CAS  Google Scholar 

  13. Bianco AF, DeParcido S, Pagliarulo C, D'Istria M, DeSio L, Ricciarde I, Delrio G. Effect of adjuvant tamoxifen and CMF on endocrine function of patients with operable breast cancer. Chemotherapia 1985; 4: 252–255.

    CAS  Google Scholar 

  14. Jordan VC, Fritz NF, Tormey DC. Endocrine effects of adjuvant chemotherapy and long-term tamoxifen administration on node-positive patients with breast cancer. Cancer Res 1987; 47: 624–630.

    PubMed  CAS  Google Scholar 

  15. Sherman BM, Chapler FK, Crickard K, Wycoff D. Endocrine consequences of continuous antiestrogen therapy with tamoxifen in premenopausal women. J Clin Invest 1979; 64: 398–404.

    Article  PubMed  CAS  Google Scholar 

  16. Sutherland RL, Reddel RR, Murphy LC, Taylor IW. Effects of antiestrogens on cell cycle progression. In: Jordan VC. Estrogen/antiestrogen action and breast cancer therapy. London: The University of Winsconsin Press. 1986; 265–281.

    Google Scholar 

  17. Lippman ME, Bolan G. Oestrogen-responsive human breast cancer in long term tissue culture. Nature 1975; 256: 592–593.

    Article  PubMed  CAS  Google Scholar 

  18. Coezy E, Borgna JL, Rochefort H. Tamoxifen and metabolite in MCH-7 cells correlation between binding to estrogen receptor and inhibition of cell growth. Cancer Res 1982; 42: 317–323.

    PubMed  CAS  Google Scholar 

  19. Daniel CP, Gaskell SJ, Bishop H, Nicholson RI. Determination of tamoxifen and an hydroxylated metabolite in plasma from patients with advanced breast cancer using gas chromatography-mass spectrometry. J Endocr 1979; 83: 401–408.

    Article  PubMed  CAS  Google Scholar 

  20. Edery M, Goussard J, Dehennin L, Scholler R, Reiffstec J, Drosdowsky MA. Endogeneous oestradiol-17 concentration in breast tumors determined by mass fragmentography and by radioimmunoassay; Relationship to receptor content. Euro J Cancer 1981; 17: 115–120.

    CAS  Google Scholar 

  21. Naitoh K, Honjyo H, Yamamoto T, Urabe M, Ogino Y, Yasumura T, Nambara T. Estrone sulfate and sulfatase activity in human breast cancer and endometrial cancer. J. Steroi Biochem 1989: (in press).

  22. Taylor SG, Kalish IV, Olson JE, Cummings F, Bennett JM, Falkson G, Tormey DC, Carbone PP. Adjuvant CMFPversus CMFP plus tamoxifenversus observation alone in postoperative node positive breast cancer patients: Three year results of an estrogen cooperative oncology group study. J Clin Oncol 1985; 3: 144–154.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. The Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Kazuo Naitoh, Takara Yamamoto, Hideo Honjyo & Hiroji Okada

  2. The Second Department of Surgery, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyoku, 602, Kyoto, Japan

    Tadaki Yasumura MD, Toshikazu Akami, Manabu Mitsuo & Takahiro Oka

Authors
  1. Tadaki Yasumura MD
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  2. Toshikazu Akami
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  3. Manabu Mitsuo
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  4. Takahiro Oka
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  5. Kazuo Naitoh
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  6. Takara Yamamoto
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  7. Hideo Honjyo
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  8. Hiroji Okada
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Yasumura, T., Akami, T., Mitsuo, M. et al. The effect of adjuvant therapy with or without tamoxifen on the endocrine function of patients with breast cancer. The Japanese Journal of Surgery 20, 369–375 (1990). https://doi.org/10.1007/BF02470819

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  • DOI: https://doi.org/10.1007/BF02470819

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