Postmenopausal endometrial pathologies with tamoxifen treatment: Comparison between hysteroscopic and hysterectomy findings

Histological findings of endometrial specimens collected by hysteroscopy fr om 261 postmenopausal breast cancer patients with tamoxifen treatment (grou p I) and from endometrial specimens obtained following hysterectomy from 40 similar patients (group II) were compared, This comparison was performed i n order to assess whether endometrial pathologies are more frequently diagn osed in specimens collected by hysterectomy than by those collected during hysteroscopy in such patients. Overall positive endometrial histological fi ndings were significantly more common in group II patients than in group I patients (82.5 and 24.5%, respectively; p < 0.0001). Atrophic endometrium w as significantly more common in group I patients than in group II patients (75.5 and 15.0%, respectively; p < 0.0001), All other different endometrial pathologies, except for proliferative endometrium, were significantly more common in group II patients than in group I patients (endometrial hyperpla sia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial polyps = 30.0 an d 11.5%, respectively; p < 0.006; endometrial polyps with hyperplasia = 17. 5 and 4.2%, respectively; p < 0.0003; endometrial carcinoma = 15.0 and 0.4% , respectively; p < 0.0001). These findings suggest that in postmenopausal breast cancer patients treated with tamoxifen, the frequency of various end ometrial histological findings and of overall positive endometrial histolog ical findings were significantly higher in specimens collected by hysterect omy than in specimens obtained by hysteroscopy.