title: Endometrial evaluation by ultrasonography, hysteroscopy and histopathology in cases of breast carcinoma on Tamoxifen therapy.
abstract: BACKGROUND
  Tamoxifen, a nonsteroidal antiestrogenic agent, is used widely as adjunctive therapy for women with breast cancer. Most studies have found that the increased relative risk of developing endometrial cancer for women taking Tamoxifen is two to three times higher than that of an age-matched population. So we designed this study to assess the endometrial status in patients taking Tamoxifen for breast carcinoma.
  
  
  METHODS
  The study was conducted at Govt. Medical College and Rajindra Hospital, Patiala, India. A total of 50 patients of Ca Breast taking Tamoxifen were selected as per study criterion and TVS performed. If endometrial thickness was more than 5 mm hysteroscopy and endometrial HPE was done and data analysed.
  
  
  RESULTS
  On ultrasonography 35 patients (70%) had an endometrial thickness up to 5 mm. 15 patients (30%) had an endometrial thickness more than 5mm. Out of these, 11 patients, i.e. 22% of total, had an endometrial thickness of 5.1 to 10 mm and 2 patients, i.e. 4% of total had an endometrial thickness of more than 20 mm. Hysteroscopy was done on 11 patients. Out of these 8 patients had a normal hysteroscopic appearance whereas 3 patients had an abnormal hysteroscopic picture. Endometrial HPE of these 11 patients revealed 2 patients had secretory changes, 1 had polyp change, 1 had atrophic endometrium, 3 had simple endometrial hyperplasia, 1 had endometrial adenocarcinoma and 4 patients were reported to have scanty curetting.
  
  
  CONCLUSIONS
  The duration of Tamoxifen therapy turned out to have a relationship with the incidence of endometrial carcinoma (P < 0.0001). Also, a relationship was observed between the duration of Tamoxifen therapy and symptom status of the patients (P < 0.0001). This correlation did not extend to duration of Tamoxifen therapy and endometrial thickness. (P = 0.190). This correlation did not extend to duration of Tamoxifen therapy and endometrial thickness. (P = 0.190).
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Patiala, Punjab, India.
authors.forename: Alka
authors.initials: A
authors.lastname: Jindal
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Patiala, Punjab, India.
authors.forename: Manjit K
authors.initials: MK
authors.lastname: Mohi
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Patiala, Punjab, India.
authors.forename: Manjeet
authors.initials: M
authors.lastname: Kaur
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Patiala, Punjab, India.
authors.forename: Balwinder
authors.initials: B
authors.lastname: Kaur
authors.affiliation: Department of Orthopaedics, Northern Railway Central Hospital, New Delhi, India.
authors.forename: Risham
authors.initials: R
authors.lastname: Singla
authors.affiliation: Department of Pharmacology, Government Medical College, Patiala, Punjab, India.
authors.forename: Shaunik
authors.initials: S
authors.lastname: Singh
keywords: Carcinoma breast; endometrial evaluation; endometrial histopathology; hysteroscopy; tamoxifen