CHEMOTHERAPY-INDUCED CHANGES IN UTERINE VOLUME - CT STUDY

Objective: The goal of this study was to quantify changes in uterine v olume during and after chemotherapy for breast cancer. Materials and M ethods: Fifty-eight patients (mean age 42 years) with advanced breast cancer undergoing treatment with FLAC (5-fluorouracil, leucovorin, Adr iamycin, and cyclophosphamide) were studied with serial pelvic CT. The transverse, anteroposterior, and sagittal measurements of the uterus were taken in each of the CT scans. The uterine volumes were calculate d, normalized to baseline volumes, and graphically displayed for each patient. The temporal changes in uterine volume were correlated to the dates of chemotherapy administration and menstrual status. Results: T here was a striking and consistent loss of uterine volume with chemoth erapy. This phenomenon was observed in 55 (95%) of the 58 patients. Th e mean minimum uterine volume was 58.3 +/- 20.2% compared with the bas eline. This loss of uterine volume began after the administration of t he first cycle of chemotherapy and progressed during subsequent cycles . It coincided with loss of normal menses in all patients. After compl etion of chemotherapy, there was a recovery of the uterine volume in 1 2 of the 16 patients who had follow-up CT. The mean recovery uterine v olume was 108.4 +/- 49.8% of baseline, Menses recovered in four of the se. Conclusion: Chemotherapy causes loss of uterine volume, which usua lly recovers after the withdrawal of chemotherapy in premenopausal wom en. This change should not be mistaken for a therapeutic response of p rimary or secondary malignancy within the uterus or be confused with s ubsequent uterine changes due to tamoxifen.