RESULTS OF CURETTAGE FOR POSTMENOPAUSAL VAGINAL BLEEDING IN WOMEN TREATED WITH TAMOXIFEN AND MEGESTROL-ACETATE FOR PROGRESSIVE METASTATIC BREAST-CARCINOMA

Tamoxifen and megestrol acetate ate used as a hormonal treatment for m etastatic breast carcinoma. It is suggested that the use of tamoxifen may induce endometrial cancer. In this article we describe nine patien ts under hormonal treatment for metastatic breast cancer with, firstly , tamoxifen and, later, megestrol acetate. These nine patients all had symptoms of postmenopausal vaginal blood loss during therapy with meg estrol acetate, an indication to perform a diagnostic dilatation and c urettage. By histopathological examination the curettings showed a dec idualized stroma with an infiltration of lymphocytes, some plasma cell s and many eosinophils. In none of the patients was atypical hyperplas ia or malignancy found. The dilatation and curettage had also a therap eutic effect, since only one of the patients still had complaints, whi le the other eight did not complain of postmenopausal bleeding again. We review the literature and discuss the value of a diagnostic dilatat ion and curettage.