Sonographic evaluation of the uterus in postmenopausal women receiving tamoxifen: characterization of mid-uterine abnormalities.
BACKGROUND
Tamoxifen is known to exert agonist estrogenic effects on the uterus. Its use in postmenopausal women has also been associated with various endometrial and uterine abnormalities that can be detected by endovaginal sonography.


OBJECTIVE
To study postmenopausal patients receiving tamoxifen who were referred for evaluation following the detection of abnormal uterine findings by endovaginal sonography.


METHODS
Fifty-two women treated with tamoxifen for breast cancer who were found to have an abnormal uterine sonogram constituted the study population. Uterine sonograms were reviewed and clinical and sonographic data were correlated with the results of the histologic examinations.


RESULTS
Forty-five women demonstrated a thickened mid-uterine structure. Of these, in thirty-nine patients (87%) either no tissue of scant fragments of normal endometrium were obtained on curettage, and six women (13%) had endometrial hyperplasia. Seven women had fluid loculation lined by thin endometrium. Their subsequent histologic examination was normal. The sonograms of the women who demonstrated an appearance of a thickened endometrium but no neoplasia, characteristically demonstrated hyperechogenic cystic area with no midline echo.


CONCLUSIONS
Among 52 postmenopausal patients receiving tamoxifen presented with an abnormal uterine sonogram, 39 (75%) women were found to have a thick mid-uterine structure resembling a thickened endometrium without histologic evidence of neoplasia. This phenomenon can be characterized by typical sonographic features, and may be differentiated from other uterine abnormalities.
Department of Obstetrics and Gynecology, Hadassah University Hospital, Mt. Scopus, Jerusalem, Israel.
E Y
EY
Anteby
S
S
Yagel
A
A
Weissman
S
S
Degani
B
B
Caspi
Z
Z
Appelman
D
D
Hochner-Celnikier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology*; D004107:Dilatation and Curettage; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects / Q000502:physiology*; D013629:Tamoxifen / Q000494:pharmacology*; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen