Endometrial abnormalities in postmenopausal breast cancer patients

To determine the prevalence of endometrial thickening and pelvic pathologies in postmenopausal breast cancer patients.

A total of 66 postmenopausal breast cancer patients receiving treatment at Srinagarind Hospital from 1 July 1999 to 31 August 2000 were included in the study. Patients who had been treated with hormones such as tamoxifen or progestins were not eligible for this study. Thorough history taking and physical examination as well as transvaginal ultrasonography were conducted in all study patients. Fractional curettage was carried out and the specimens obtained were sent for pathological examination in all patients whose endometrial thickness was found to be greater than 5 mm on the ultrasound scan.

Among the 66 patients included in this study, the mean age was 54.97 years. The majority of patients (75.76%) had stage II disease. The mean +/- SD of endometrial thickness found in this study was 3.55 +/- 1.72 mm. The prevalence of thickened endometrium (defined as ET > 5 mm from TVS) was 10.60% (7 from 66 cases). Other pelvic pathologies detected by ultrasonography were myoma uteri (4.55%) and ovarian mass (1.52%). Among the seven patients whose endometrial thickness was found to be greater than 5 mm, results of curettage specimens revealed inadequate tissue obtained (42.85%), atrophic endometrium (28.57%), active endometrial gland (14.29%), and scanty stromal cell (14.29%).

The prevalence of thickened endometrium in postmenopausal breast cancer patients found in this study was interestingly high. The pathological results of such cases, however, turned out to be negative for neoplastic changes in all cases. Further study, thus, is needed before precise recommendation could be made regarding the value of TVS screening in breast cancer patients not taking tamoxifen.