title: The endometrium in breast cancer patients on tamoxifen.
abstract: We restudied histologically and immunohistochemically 17 endometrial carcinomas, 2 malignant mixed tumors and 180 endometria with benign changes during or after tamoxifen therapy. The carcinomas were subtyped according to the 1994 WHO-classification. Endometrial biopsies were taken only if the endometrial thickness was > 8 mm sonographically, when a polyp was seen, or for postmenopausal bleeding. About half of the endometrial specimens showed simple or cystic atrophy, 55-76% had cystic-atrophic polyps or regressive hyperplasia. Depending upon the dose of tamoxifen, 7-19% (30 mg) to 27-36% (20 mg) showed moderate glandular proliferation. 20-33% had foci of mucinous, clear cell or serous-papillary metaplasia. 68-70% revealed diffuse extensive fibrosis of the endometrial stroma. None of 11 patients biopsied before starting tamoxifen therapy had advanced endometrial glandular proliferation in the second endometrial biopsy after tamoxifen treatment. None of the 19 endometrial neoplasms after tamoxifen therapy was of the endometrioid type: 11 were mucinous adenocarcinomas, 4 clear cell carcinomas, 2 serous-papillary carcinomas, one carcinosarcoma and one malignant Mullerian mixed tumor. The reasons for discrepancies between suspicious sonograms and endometrial atrophy are discussed.
authors.affiliation: Institut für Pathologie, Mannheim.
authors.forename: G
authors.initials: G
authors.lastname: Dallenbach-Hellweg
authors.forename: D
authors.initials: D
authors.lastname: Schmidt
authors.forename: P
authors.initials: P
authors.lastname: Hellberg
authors.forename: T
authors.initials: T
authors.lastname: Bourne
authors.forename: E
authors.initials: E
authors.lastname: Kreuzwieser
authors.forename: M
authors.initials: M
authors.lastname: Dören
authors.forename: W
authors.initials: W
authors.lastname: Rydh
authors.forename: G
authors.initials: G
authors.lastname: Rudenstam
authors.forename: S
authors.initials: S
authors.lastname: Granberg
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology; D002288:Adenocarcinoma, Mucinous / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy*; D002296:Carcinosarcoma / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology; D018283:Cystadenocarcinoma, Papillary / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology; D016889:Endometrial Neoplasms / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology*; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology; D011127:Polyps; D012189:Retrospective Studies; D013629:Tamoxifen / Q000009:adverse effects*; D018615:Ultrasonography, Doppler, Color
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen