Cervical HPV Prevalence in Breast Cancer Patients on Tamoxifen Maintenance Therapy

INTRODUCTION: This study aimed to analyze cervical smear results and determine the prevalence of HPV in women using tamoxifen for breast cancer.
METHODS: This single-center retrospective study included patients using tamoxifen for breast cancer who had undergone cervical smear sampling with HPV testing at Ondokuz Mayis University Faculty of Medicine Hospital between February 2015 and March 2022. Statistical analyses were performed using non-parametric statistical tests (Kruskal-Wallis and Dunn tests). Quantitative data were analyzed with SPSS.
RESULTS: Of 252 breast cancer patients who underwent cervical smear sampling with HPV testing, 199 met the inclusion criteria. Oncogenic HPV positivity was detected in 12 patients (6.03%). Normal cytology was found in 158 patients (79.4%), while abnormal results included ASC-US in 29 (14.6%), ASC-H in 7 (3.5%), LSIL in 3 (1.5%), and AGC-NOS in 2 (1.0%). Among 105 patients (52.8%) who had endometrial sampling, 60 (30.2%) had endometrial polyps. The mean endometrial thickness in those with polyps was 12.75 ± 6.37 mm. The most common comorbidity was thyroid disease, found in 28.8% of patients.
DISCUSSION AND CONCLUSION: The prevalence of cervical HPV in women using tamoxifen for breast cancer was 6.03%. Endometrial polyps were the most common endometrial pathology among patients who underwent sampling. Although further studies are needed, women using tamoxifen may benefit from appropriate counseling regarding cervical and endometrial follow-up, as well as primary and secondary preventive strategies.

Keywords: cervical cancer, cervical smear, breast cancer, tamoxifen, HPV DNA