A randomized, prospective study of endometrial resection to prevent recurrent endometrial polyps in women with breast cancer receiving tamoxifen

Study Objective. To assess the role of endometrial resection in preventing recurrence of tamoxifen-associated endometrial polyps in women with breast cancer. Design. Randomized, prospective study (Canadian Task Force classification I ). Setting. Tertiary university-affiliated medical center. Patients. Twenty consecutive women (age range 43-61 yrs). Interventions. Hy steroscopic removal of tamoxifen-associated endometrial polyps with or with out simultaneous resection of the endometrium. Measurements and Main Results, Patients were randomized to undergo (10 wome n) or not undergo (10) concomitant endometrial resection. They were followe d for at least 18 months (range 18-24 mo), including transvaginal ultrasono graphy every 6 months and hysteroscopy when endometrial irregularity was no ted. The main outcome variable was recurrence of endometrial polyps; occurr ence of uterine bleeding was also noted. In women who underwent endometrial resection, only one had a 1 x 1-cm endometrial polyp diagnosed and removed during follow-up. Seven women remained amenorrheic, and three experienced spotting for a few days every month. In the control group, six women had re current endometrial polyps requiring hysteroscopic removal (two-tail Fisher 's exact test p <0.06). Conclusion. Recurrence of endometrial polyps, one of the most common proble ms in patients with breast cancer receiving long-term treatment with tamoxi fen, may be reduced by performing endometrial resection at the time of hyst eroscopic removal of polyps. The possible risk of occult endometrial cancer is yet to be determined.