Understanding Endometrial Cancer Risks in Breast Cancer Survivors: A Clinical Perspective

Recent studies are uncovering a critical area of concern for breast cancer survivors: their heightened risk of developing endometrial cancer. With current research shedding light on this connection, clinicians are called to explore prevention strategies and the broader implications for patient care.

Endocrine mechanisms—particularly cumulative estrogen exposure and tamoxifen’s partial agonist effects on the endometrium—can increase endometrial cancer risk among some breast cancer survivors. A recent matched cohort study found higher endometrial cancer rates, particularly among tamoxifen-treated patients. As highlighted in a study on Endometrial Cancer Risk, breast cancer survivors have a higher incidence of endometrial cancer than their counterparts in the general population (matched cohort design; risk elevation was greater among tamoxifen-exposed patients).

Guidelines from the NCCN emphasize genetic evaluation when indicated—such as suspected hereditary cancer syndromes like Lynch—and note that molecular classification is primarily used to inform endometrial tumor management rather than as routine screening for all breast cancer survivors. When indicated—such as in suspected hereditary syndromes—tools like germline genetic testing or, in the setting of an endometrial tumor, molecular classification can inform management and follow-up planning.