Comparison of endometrial pathologies collected by hysteroscopy and hysterectomy in postmenopausal breast cancer tamoxifen-treated patients.
OBJECTIVE
1) To assess whether endometrial specimens obtained from removed uteri might show an increase in endometrial pathologies which had been previously diagnosed by hysteroscopy in postmenopausal breast cancer tamoxifen-treated patients. 2) To assess whether hysteroscopy is an efficient method of detecting endometrial pathologies in such patients.


METHODS
The findings of two consecutive pathological evaluations in 18 postmenopausal breast cancer tamoxifen-treated patients, performed 11.2+/-11.2 months apart, were compared. The first specimen was collected by hysteroscopy and the second was obtained following hysterectomy.


RESULTS
The most significant changes observed were three new cancers diagnosed at hysterectomy, one of which was poorly-differentiated. In the first (hysteroscopy) samplings, one patient had atrophic endometrium, a second patient had endometrial proliferation and a third patient had a benign endometrial polyp. Overall, 55.6% of the study patients had various endometrial pathologies in the first sampling, while 83.3% had endometrial pathologies in the second sampling. However, this difference was not statistically significant.


CONCLUSIONS
1) Endometrial histologic evaluations, performed on removed uteri 11.2+/-11.2 months following previous endometrial samplings of postmenopausal breast cancer tamoxifen-treated patients, showed a non-significant risk of developing overall endometrial pathologies. 2) Hysteroscopy may have missed some endometrial pathologies which were diagnosed later on in specimens obtained by hysterectomy.
Cohen
I
I
Department of Obstetrics & Gynaecology, Sapir Medical Center, Kfar-Saba, Israel.
Azaria
R
R
Bernheim
J
J
Tepper
R
R
Sharony
R
R
Beyth
Y
Y
D000368:Aged; D001284:Atrophy; D001943:Breast Neoplasms / Q000517:prevention & control*; D002277:Carcinoma / Q000139:chemically induced / Q000473:pathology; D004714:Endometrial Hyperplasia / Q000139:chemically induced / Q000473:pathology; D016889:Endometrial Neoplasms / Q000139:chemically induced / Q000473:pathology* / Q000601:surgery; D004717:Endometrium / Q000187:drug effects / Q000473:pathology*; D004965:Estrogen Antagonists / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy / Q000592:standards*; D011127:Polyps / Q000139:chemically induced / Q000473:pathology; D017698:Postmenopause; D011237:Predictive Value of Tests; D013629:Tamoxifen / Q000009:adverse effects*
D004965:Estrogen Antagonists; D013629:Tamoxifen