[Ultrasound endometrium follow-up during tamoxifen treatment: Really not reliable or useful after all?].
OBJECTIVE
To investigate whether an examination of the endometrium of women treated with tamoxifen (TAM) is useful or not.


METHODS
40 breast cancer patients who displayed a thickened endometrium of > 8 mm and/or vaginal bleeding were included in the study. They received daily TAM adjuvantly. Histologic clarification by hysteroscopy and D&C was recommended for patients with an endometrium of > 8 mm or vaginal bleeding.


RESULTS
In our collective, the mean endometrial thickness was 13.7 +/- 5.6 mm (SD). 32 patients underwent a histological examination. Most had a benign lesion; in 2 cases we merely found a cystic atrophy (11 mm, 18 mm), 2 displayed atypical tissue (13 mm, 25 mm) and 2 an endometrial cancer (19 mm, 33 mm). All patients with atypical tissue or cancer had an endometrial thickness markedly above the norm, but 3 of them were not bleeding. No linear correlation between thickness of the endometrium and duration of TAM intake was found.


CONCLUSIONS
To detect early premalignant or malignant changes of the endometrium, we recommend histological examination by hysteroscopy and dilatation and curettage when the endometrium is > 8 mm thick, even in the absence of symptoms. Therefore, these patients should have regular examinations by transvaginal ultrasound once or twice a year. Moreover, continuing regular screening of the endometrium for years after termination of tamoxifen-therapy is also to be recommended.
Burkart
C
C
Klinik für Gynäkologie, Dept. Frauenheilkunde, Universitätsspital Zürich, Schweiz.
Wight
E
E
Pók
J
J
Kernen
B
B
Traber
M
M
Haller
U
U
Bajka
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy*; D004714:Endometrial Hyperplasia / 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; D019160:Endosonography; D005260:Female; D006801:Humans; D008875:Middle Aged; D012016:Reference Values; D012680:Sensitivity and Specificity; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use
D013629:Tamoxifen