[Monitoring women on tamoxifen ]

Worldwide, 7 million women are taking tamoxifen for breast cancer. The beneficial effects of tamoxifen on patient survival have been clearly demonstrated. Tamoxifen has few adverse effects and severe complications are very uncommon. An higher risk of endometrial cancer at the 20 mg/d dosage has been discussed and if it does exist, is minimal (RR x 2 instead of 1.3). Patient monitoring is basically clinical with an annual examination of the lower limbs and genital organs and an ophthalmological examination. Further explorations are needed in cases with specific symptoms, especially metrorrhage. There has been no proof that systematic endometrial cytology or ultrasound explorations are useful.