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BTamoxifen may cause changes in the lining of the uterus. An early sign of these changes may be abnormal vaginal bleeding or pelvic pain. After an average of 8 years of follow-up, the annual (per year) risk observed in a large-scale trial of breast cancer patients taking 20 mg of tamoxifen daily is about 2 per 1,000 women. This means that on the average, two cases of endometrial cancer were diagnosed among every 1000 women receiving tamoxifen during each year of the study and follow-up. This level of risk is approximately three times greater than that of a similar group of women in the general population.
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