Abnormalities detected on transvaginal ultrasonography in tamoxifen-treated postmenopausal breast cancer patients may represent endometrial cystic atrophy.
OBJECTIVE
This study was conducted to examine the histopathologic changes in tamoxifen-treated postmenopausal patients with endometrial thickness > or = 5 mm with transvaginal ultrasonography.


METHODS
Thirty-five tamoxifen-treated postmenopausal breast cancer patients underwent transvaginal pelvic ultrasonography with endometrial thickness > or = 5 mm followed by either curettage-hysteroscopy (n = 24), or hysterectomy (n = 11). Endometrial histopathologic findings were examined.


RESULTS
Overall, endometrial polyps were the most common histopathologic finding (23 of 35 patients). Endometrial cystic atrophy was uncommonly detected in patients undergoing curettage-hysteroscopy (1 of 24 patients) compared with patients undergoing hysterectomy (9 of 11 patients). No cases of endometrial cancer or hyperplasia were detected.


CONCLUSIONS
Endometrial polyps were a frequent finding in tamoxifen-treated postmenopausal women who had endometrial thickness > or = 5 mm with the use of transvaginal ultrasonography. Endometrial cystic atrophy may explain "thickened endometrium" on transvaginal ultrasonography in this patient population with no evidence of endometrial polyps, hyperplasia, or adenocarcinoma after surgical evaluation.
McGonigle
K F
KF
Department of Gynecology, City of Hope National Medical Center, Duarte, California, USA.
Shaw
S L
SL
Vasilev
S A
SA
Odom-Maryon
T
T
Roy
S
S
Simpson
J F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001284:Atrophy; D001943:Breast Neoplasms / Q000188:drug therapy*; D003475:Curettage; D003560:Cysts / Q000000981:diagnostic imaging*; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011127:Polyps / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology; D017698:Postmenopause / Q000502:physiology*; D012189:Retrospective Studies; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014463:Ultrasonography; D014591:Uterine Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen