Pengaruh Periode Penggunaan Tamoxifen Terhadap Kejadian Endometriosis Pada Penderita Kanker Payudara

Marshal Agreno, Noer Faisal Darmi, Jufriady Ismy, Ferry Erdani, Imam Hidayat
In: Journal Of The Indonesian Medical Association · 2022 · vol. 71(6) , pp. 259–266 · doi:10.47830/jinma-vol.71.6-2021-447 · W4283208015
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Abstract

Pendahuluan: Tamoxifen (selective estrogen receptor modulator) merupakan standar terapi hormonal pada wanita penderita kanker payudara dengan reseptor estrogen positif. Penggunaan regimen ini terbukti mengurangi kejadian relaps lokal, kolateral atau pada area tubuh yang jauh serta menurunkan mortalitas kanker payudara. Salah satu efek tamoksifen adalah menginduksi terjadinya proliferasi endometrium, sehingga dapat menimbulkan berbagai kelainan pada jaringan endometrium.Metode: Penelitian ini merupakan penelitian analitik komparatif katagorik tidak berpasangan dengan desain single cohort (internal comparison group) secara retrospektif. Seluruh penderita kanker payudara di RSUD dr. Zainoel Abidin Banda Aceh sejak tahun 2017 – 2019 dilibatkan pada penelitian ini. Evaluasi terhadap kejadian endometriosis dilakukan berdasarkan durasi penggunaan tamoxifen menggukan Uji Mann Whitney U test.Hasil: Sebanyak 114 pasien (46,15%) dilaporkan mengalami endometriosis dari total 247 pasien kanker payudara yang menggunakan tamoksifen dengan rata-rata usia 49 tahun. Sebagian besar penderita terdiagnosis sebagai kanker payudara stadium IIIB dengan jenis ductal cell carncinoma. Sebanyak 111 orang (97,37%) mengalami endometriosis setelah penggunaan tamoxifen selama 30 – 36 bulan dan 3 (2,63%) sisanya setelah 24 – 29 bulan. Durasi penggunaan rata – rata tamoxifen yang berkaitan dengan kejadian endometriosis adalah 34 bulan (p < 0,001).Kesimpulan: Penggunaan tamoxifen jangka panjang pada pasien kanker payudara meningkatkan risiko kejadian endometriosis
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Abstract

Introduction: Tamoxifen (selective estrogen receptor) is the standard hormonal therapy in women with breast cancer with positive estrogen receptor. The use of this regimen proved to reduce the incidence of relapse at local, collateral, or distant body area, and also decrease breast cancer mortality. One of the effects of tamoxifen is to induce endometrial proliferation, cause various abnormalities in endometrial tissue.

Method

This study is an unpaired categorical comparative analytic study with a retrospective single cohort (internal comparison group) design. All breast cancer patients at dr. Zainoel Abidin Banda Aceh from 2017 - 2019 was involved in this research. Evaluation of the incidence of endometriosis was carried out based on the duration of tamoxifen using the Mann-Whitney U test. This study is an unpaired categorical comparative analytic study with a retrospective single cohort (internal comparison group) design. All breast cancer patients at dr. Zainoel Abidin Banda Aceh from 2017 - 2019 was involved in this research. Evaluation of the incidence of endometriosis was carried out based on the duration of tamoxifen using the Mann-Whitney U test.

Result

A total of 114 patients (46.15%) out of a total of 247 breast cancer patients using tamoxifen reported experiencing endometriosis with a mean age of 49 years old. Most of the patients diagnosed with stage IIIB breast cancer of ductal cell carcinoma. A total of 111 people (97.37%) experienced endometriosis after taking tamoxifen for 30-36 months and the remaining 3 (2.63%) after 24-29 months. The mean duration of tamoxifen use associated with endometriosis was 34 months (p less than 0.001).

Conclusion

Long-term use of tamoxifen in breast cancer patients increases the risk of endometriosis

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