Hysteroscopic evaluation of the endometrium in postmenopausal women takingtamoxifen

Study Objective. To evaluate hysteroscopic endometrial changes due to tamox ifen therapy in postmenopausal women with breast cancer. Design, Retrospective study (Canadian Task Force classification II-2). Setting. University-affiliated hospital. Patients. Eighty-eight postmenopausal women (or with iatrogenic amenorrhea) receiving tamoxifen 20 mg/day for at least 7 year for breast cancer. Intervention. Record review of patients undergoing transvaginal sonography (TVS) and office hysteroscopy with eye-directed biopsy specimens obtained w ith a 5-mm, continuous-Flow operative hysteroscope. Measurements and Main Results, Patients with thickened endometrium and path ologic findings at hysteroscopy had taken tamoxifen for significantly longe r times than those without such findings (p < 0.05). Conclusion. Our findings confirm the estrogenic effect of tamoxifen on endo metrium. Endometrial evaluation by TVS suggests further diagnostic procedur es, but only hysteroscopy allows the surgeon to Visualize endometrial lesio ns and obtain eye-directed biopsy tissue.