Fphlj. Dijkhuizen et al., TRANSVAGINAL ULTRASONOGRAPHY AND ENDOMETRIAL CHANGES IN POSTMENOPAUSAL BREAST-CANCER PATIENTS RECEIVING TAMOXIFEN, Maturitas, 25(1), 1996, pp. 45-50
Citations number
24
Categorie Soggetti
Geiatric & Gerontology","Obsetric & Gynecology","Medicine, General & Internal
Objectives: To assess an estrogenic effect of tamoxifen on the uterus
and to evaluate the usefulness of transvaginal ultrasonography for ide
ntifying tamoxifen-induced endometrial pathology. Methods: One hundred
and two postmenopausal breast cancer patients without gynecological s
ymptoms were examined by transvaginal ultrasonography. Forty-eight pat
ients were treated with tamoxifen and 54 patients served as reference.
An endometrial thickness of greater than or equal to 6 mm (double-lay
er) was used as cut-off point for further hysteroscopic and histologic
examination. Results; Thirty percent of the women taking tamoxifen ha
d 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). Furthermo
re, 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. Conclus
ions: Our data indicate that tamoxifen stimulates the uterine body and
endometrium. The data also indicate that the ultrasonographic endomet
rial appearance during tamoxifen therapy may be misleading and that a
high percentage (46%) of false-positive results occur. Therefore, in a
symptomatic postmenopausal breast cancer patients taking tamoxifen, th
e findings on ultrasonography should be interpreted with caution.