Hysteroscopic dynamic assessment of the endometrium in patients treated with long-term tamoxifen
Tirso Pérez-Medina1, Francisco J Salazar, Luis San-Frutos
1Obstetrics Department, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain. tperezm@sego.es
Study Objective:
To describe the evolutive endometrial hysteroscopic patterns in patients undergoing long-term tamoxifen treatment.
Design:
Prospective analysis. Analysis of variance test with post hoc Bonferroni test and homogeneity test of percentages were used for hypothesis contrast between the groups.
Design Classification:
Canadian task force II-2.
Setting:
Four Spanish tertiary care hospitals.
Patients:
A total of 278 patients with breast cancer diagnosed between 2002 and 2004, which completed 5-years adjuvant therapy with tamoxifen.
Interventions:
Ultrasonography and hysteroscopic explorations were performed before starting the treatment and then at yearly intervals during the 5 years of adjuvant treatment.
Measurements And Main Results:
Hysteroscopic endometrial changes were significant throughout the years of treatment. Tamoxifen-exposed endometria present five different patterns: atrophic, cystic, hypervascularized, endometrial polyp, and suspicious of malignancy. Endometrial carcinoma appeared in four patients (1.5%) that bled during the follow-up.
Conclusion:
Tamoxifen produces five different endometrial patterns that evolve dynamically throughout the 5 years of treatment.
