Current or prior tamoxifen exposure ≥5 years in a woman with intact uterus (no prior hyst...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`RF-IATROGENIC-TAMOXIFEN-ENDOMETRIAL-PREVENTION`
Тип	Тривожна ознака
Статус	переглянуто 2026-05-18 \| очікує клінічного підпису
Хвороби	`DIS-ENDOMETRIAL`
Джерела	`SRC-NCCN-BREAST-2025` `SRC-NCCN-UTERINE-2025`

Походження тривожної ознаки

Визначення	Current or prior tamoxifen exposure ≥5 years in a woman with intact uterus (no prior hysterectomy). Tamoxifen is a selective estrogen- receptor modulator (SERM) — antagonist in breast tissue (therapeutic for ER+ breast cancer + risk reduction) but partial agonist in endometrium → ~2-7 fold increased endometrial cancer risk (predominantly endometrioid; less commonly serous, carcinosarcoma). Cumulative risk ~1-2% over 5y treatment; higher with longer duration + post-menopausal status. Endometrial cancers in tamoxifen-exposed women often more aggressive histology than spontaneous. Population with hysterectomy: this RF does NOT fire (no at-risk organ). Patient with ER+ breast cancer (treatment-time persona) ALSO has prevention- persona considerations covered by this RF. Prevention-persona RedFlag (§20 v0.3 iatrogenic pilot).
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "current_tamoxifen_use_ge_5y",
      "value": true
    },
    {
      "finding": "prior_tamoxifen_completion_intact_uterus",
      "value": true
    },
    {
      "finding": "tamoxifen_post_menopausal_intact_uterus",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

Prevention-persona RedFlag for tamoxifen exposure ≥5y in women with intact uterus. ~2-7 fold endometrial cancer risk. Engine routes to PreventionPlan recommending symptom-prompted evaluation (postmenopausal bleeding → immediate workup with TVUS + endometrial biopsy). Routine asymptomatic TVUS screening NOT recommended per ACOG (false-positives from tamoxifen-related subepithelial changes). STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

Де використовується

Indications

IND-IATROGENIC-TAMOXIFEN-ENDOMETRIAL-PREVENTION-OBSERVATION - IND-IATROGENIC-TAMOXIFEN-ENDOMETRIAL-PREVENTION-OBSERVATION
IND-IATROGENIC-TAMOXIFEN-ENDOMETRIAL-PREVENTION-SURVEILLANCE - IND-IATROGENIC-TAMOXIFEN-ENDOMETRIAL-PREVENTION-SURVEILLANCE

Тривожна ознака

RF-IATROGENIC-COMBINED-HRT-PREVENTION - Cumulative use of combined hormone replacement therapy (estrogen + progestin / progestoge...