Unerwünschte gynäkologische und operative Interventionen bei der behandlung des postmenopausalen mammakarzinoms mit anastrozol und tamoxifen

Aim: This study was performed to investigate whether the data of the Anastrozole, Tamoxifen, Alone or in Combination (ATAC) trial provides evidence that treatment with anastrozole results in a lower incidence of gynaecological adverse events (AE) than tamoxifen. Materials and Methods: In 6186 postmenopausal patients receiving anastrozole or tamoxifen in the main ATAC trial and in those 4465 women who had an intact uterus at the baseline time of the study, a retrospective analysis of all gynaecological AEs and interventions was conducted. Results: Patients treated with tamoxifen experienced significantly more gynaecological AEs than those taking anastrozole (34.2 vs 20.5 %; p < 0.0001). This led to more diagnostic and/or therapeutic interventions, including an almost 4-fold increase in the hysterectomy rate (5.1 vs. 1.3 %; p < 0.0001). The majority of gynaecological AEs with tamoxifen occurred during the first 2.5 years of treatment. Conclusion: The lower incidence of gynaecological adverse events and interventions with anastrozole and the early occurrence of AEs offer further support for the use of anastrozole as the initial adjuvant treatment in postmenopausal patients with early hormone receptor-positive breast cancer. However, the oncological parameters and the side-effect profile of anastrozole need to be considered in the individual patient.