Inhibitory role of Metformin for tamoxifen induced uterine cell proliferation in diabetic patients with ER-positive Breast cancer
The objective of the current work to evaluate the role of metformin in inhibiting the tamoxifen induced endometrial changes in diabetic patients with ER-positive breast cancer, a case-control study, carried out between December 2018 to May 2019, forty diabetic women in postmenopausal phase with ER+ breast cancer on tamoxifen (20mg/day), metformin (1700 mg/day) GROUP A, and 40 diabetic patients with ER+ breast cancer on the same dose of tamoxifen, but other hypoglycemic agent GROUP B, were selected as controls. Uterine thickness was assessed by ultrasonography imaging at the beginning of treatment with tamoxifen and after 2 years of treatment. Hysteroscopy was done, and pathological findings also recorded. Mean uterine thickness of diabetic patients on other hypoglycemic was significantly higher than diabetic patients on metformin (14.79±3.6 vs 4.37±1.8). Uterine thickness >5mm were 2 (5%) vs 36 (85%) reported with the diabetic patient on metformin and the diabetic patient on other oral hypoglycemic group. Three cases (7.5%) of the diabetic patients on other hypoglycemic agent were developed uterine polyps, and one case (2.5%) of diabetic patients on metformin were developed uterine polyps. One case (2.5%) of uterine carcinoma was reported with diabetic patients on other hypoglycemic group. In conclusions metformin significantly inhibit tamoxifen-induced endometrial changes and offers favorable endometrium protection.
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