The role of endovaginal ultrasonography and the value of endometrial biopsy in breast cancer patients on tamoxifen therapy.
BACKGROUND
Endometrial changes have been observed when tamoxifen is used as an adjuvant therapy for carcinoma of the breast in postmenopausal women with positive estrogen receptors status.


OBJECTIVE
The aim of this study was to evaluate endometrial response in similar patients in Malaysia.


METHODS
Between February-July 1995, 38 women who had been receiving tamoxifen therapy were analysed for endometrial thickness by transvaginal ultrasonography and histopathological changes in endometrial biopsy samples. The results were compared with a similar group of postmenopausal women who did not have carcinoma of the breast. In the study group, tamoxifen was administered daily at a dose of 20-40 mg. All patients were above 50 years of age. The mean duration of tamoxifen therapy was 21.2 months (range 8-36 months).


RESULTS
Detectable differences in endometrial thickness were seen between tamoxifen and control groups. Eighteen (47%) patients in the study group had endometrial thickness in excess of 10 mm; the mean thickness being 10.7 mm (+/- 4.95 mm) which was significantly greater than the control group. Positive histological findings were found in 17 patients (45%) compared to 7 patients (18%) in the control group. Endometrium was reported to be atrophic when endometrial thickness was less than 5 mm. The study underscores the need for endometrial surveillance in breast cancer patients who are on continuous tamoxifen therapy for more than 12 months and have an endometrial thickness exceeding 8 mm.
Sivalingam
N
N
Department of Obstetrics & Gynaecology, General Hospital Ipoh, Perak, West Malaysia.
Pathmalingam
A
A
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004714:Endometrial Hyperplasia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D013629:Tamoxifen / Q000009:adverse effects*; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging*
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen