Uterine pathologies in patients undergoing tamoxifen therapy for breast cancer: ultrasonographic, hysteroscopic and histological findings.
OBJECTIVE
To evaluate endometrial abnormalities by ultrasonography, hysteroscopy and biopsy in postmenopausal patients treated with tamoxifen as adjuvant therapy for breast cancer.


METHODS
The study was carried out on 113 patients who underwent vaginal ultrasonography, hysteroscopy and endometrial biopsy.


RESULTS
There was a significative relation between ultrasonographic and hysteroscopic features (p < 0.001); 58 polyps were diagnosed at hysteroscopy, although 35 were not found at ultrasonography. A significant relation between ultrasonographic and histological findings was also documented (p < 0.005). A significant relation between histological findings and symptomatology was found (p < 0.05), although pathologies were also present in asymptomatic women.


CONCLUSIONS
These results show that long-term tamoxifen therapy in breast cancer patients is associated with a higher incidence of uterine pathology. No significant relation has been documented between duration of treatment and grade of endometrial lesion (p > 0.05). Ultrasonography alone is useful in asymptomatic patients because it selects patients with increased endometrial thickness who should undergo hysteroscopy. Hysteroscopy is more accurate in detecting polyps, hyperplastic and neoplastic changes. Asymptomatic tamoxifen treated women should be evaluated as symptomatic patients.
Le Donne
M
M
Department of Gynecological, Obstetric Sciences and Reproductive Medicine, University of Messina, Italy.
Lentini
M
M
De Meo
L
L
Benedetto
V
V
Mesiti
M
M
Misiti
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy; D017024:Chemotherapy, Adjuvant; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis; D017698:Postmenopause; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects*; D014463:Ultrasonography / Q000379:methods; D014591:Uterine Diseases / Q000175:diagnosis* / Q000209:etiology
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen