Transvaginal ultrasonography and endometrial changes in postmenopausal breast cancer patients receiving tamoxifen
Objectives: To assess an estrogenic effect of tamoxifen on the uterus and to evaluate the usefulness of transvaginal ultrasonography for identifying tamoxifen-induced endometrial pathology. Methods: One hundred and two postmenopausal breast cancer patients without gynecological symptoms were examine...
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| Published in: | Maturitas Vol. 25; no. 1; pp. 45 - 50 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Shannon
Elsevier Ireland Ltd
01-08-1996
Elsevier Science |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Objectives: To assess an estrogenic effect of tamoxifen on the uterus and to evaluate the usefulness of transvaginal ultrasonography for identifying tamoxifen-induced endometrial pathology.
Methods: One hundred and two postmenopausal breast cancer patients without gynecological symptoms were examined by transvaginal ultrasonography. Forty-eight patients were treated with tamoxifen and 54 patients served as reference. An endometrial thickness of ≥6 mm (double-layer) was used as cut-off point for further hysteroscopic and histologic examination.
Results: Thirty percent of the women taking tamoxifen had evidence of an abnormal postmenopausal endometrium compared with 6% in the reference group (
P = 0.005). Those patients receiving tamoxifen had a significantly thicker endometrium (median 6.0 mm versus 2.0 mm;
P < 0.001), a larger uterine volume (median 93 cm
3 versus 72 cm
3;
P = 0.03) and more uterine fluid (12% versus 2%;
P = 0.005). Furthermore, an ultrasonographic suspect ‘Swiss-cheese’ endometrial pattern was noted in almost a quarter of the patients treated with tamoxifen, but this was clearly not associated with intracavitary pathology.
Conclusions: Our data indicate that tamoxifen stimulates the uterine body and endometrium. The data also indicate that the ultrasonographic endometrial appearance during tamoxifen therapy may be misleading and that a high percentage (46%) of false-positive results occur. Therefore, in asymptomatic postmenopausal breast cancer patients taking tamoxifen, the findings on ultrasonography should be interpreted with caution. |
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| ISSN: | 0378-5122 1873-4111 |
| DOI: | 10.1016/0378-5122(96)01043-2 |