• M Le Donne, M Lentini, L De Meo, V Benedetto, M Mesiti, and M Misiti.
• Department of Gynecological, Obstetric Sciences and Reproductive Medicine, University of Messina, Italy.
• Eur J Gynaecol Oncol. 2005 Jan 1; 26 (6): 623-6.

Purpose Of InvestigationTo evaluate endometrial abnormalities by ultrasonography, hysteroscopy and biopsy in postmenopausal patients treated with tamoxifen as adjuvant therapy for breast cancer.MethodsThe study was carried out on 113 patients who underwent vaginal ultrasonography, hysteroscopy and endometrial biopsy.ResultsThere was a significative relation between ultrasonographic and hysteroscopic features (p < 0.001); 58 polyps were diagnosed at hysteroscopy, although 35 were not found at ultrasonography. A significant relation between ultrasonographic and histological findings was also documented (p < 0.005). A significant relation between histological findings and symptomatology was found (p < 0.05), although pathologies were also present in asymptomatic women.ConclusionsThese results show that long-term tamoxifen therapy in breast cancer patients is associated with a higher incidence of uterine pathology. No significant relation has been documented between duration of treatment and grade of endometrial lesion (p > 0.05). Ultrasonography alone is useful in asymptomatic patients because it selects patients with increased endometrial thickness who should undergo hysteroscopy. Hysteroscopy is more accurate in detecting polyps, hyperplastic and neoplastic changes. Asymptomatic tamoxifen treated women should be evaluated as symptomatic patients.

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