Endometrial pathology in postmenopausal tamoxifen treatment: comparison between gynaecologically symptomatic and asymptomatic breast cancer patients

Aims-To evaluate whether endometrial pathology is more likely to be diagnos ed in gynaecologically symptomatic rather than in gynaecologically asymptom atic postmenopausal breast cancer patients with tamoxifen treatment; and to evaluate the possible influence of various clinical factors on the inciden ce of endometrial pathology. Methods-Endometrial histological findings, transvaginal ultrasonographic en dometrial thickness, demographic characteristics, health habits, and risk f actors for endometrial cancer were compared between 14 gynaecologically sym ptomatic (group I) and 224 gynaecologically asymptomatic (group II) postmen opausal breast cancer patients with tamoxifen treatment. Results-Overall, 28.6% of the study population had endometrial pathology. T he incidence of overall positive endometrial histological findings was sign ificantly higher in group I than in group II (92.9% v 24.6%, p < 0.0001). A trophic endometrium was more common in group II than in group I (75.3% v 7. 1%, p < 0.0001). Most other endometrial pathology was significantly more co mmon in group I than in group UI (endometrial hyperplasia, 35.7% v 5.6%, p < 0.0001; endometrial polyps, 35.7% v 13.4%, p < 0.0111; endometrial carcin oma, 21.5% v 0.9%, p < 0.0001). Endometrial pathology appeared considerably later ia the gynaecologically asymptomatic patients than in gynaecological ly symptomatic patients (p = 0.0002). Vaginal bleeding or spotting occurred exclusively in group I. The incidence of endometrial pathology in the enti re study population Mras consistent with that reported elsewhere, and highe r than that reported for healthy postmenopausal women. Conclusions-Endometrial pathology is more likely to be diagnosed In gynaeco logically symptomatic postmenopausal breast cancer patients with tamoxifen treatment, and after a shorter duration of time, than in gynaecologically a symptomatic patients.