TAMOXIFEN ASSOCIATED UTERINE PATHOLOGY IN BREAST-CANCER PATIENTS WITHABNORMAL BLEEDING

The purpose of this study was to evaluate the underlying pathology in breast cancer patients treated with tamoxifen who present with abnorma l bleeding. A total of 56 cases were studied and the histopathologic f eatures of 50 curettage and 18 laparotomy specimens were reviewed. All patients were under tamoxifen treatment (10-40 mg daily) for a period ranging from 5 months to 15 years. Cervical and endometrial polyps we re the most common finding in the D and C material (44%). Hyperplasia was the most frequent feature identified at hysterectomy, often combin ed with leiomyomas, adenomyosis and ovarian tumors. Five primary adeno carcinomas of the endometrium, most of them Stage I beta, Grade I, min imally invading, were found as well. These data support the hypothesis that tamoxifen exerts a proliferative estrogen-like effect on the ute rus. Abnormal bleeding in women under TAM treatment warrants prompt in vestigation and careful follow up of the patients.