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[A hysteroscopic and anatomicopathological study in women with breast cancer]
M A Gonçalves1, W J Gonçalves, M Matias
1Dipartimento di Ginecologia e Ostetricia, Facoltà di Medicina, Pontificia Università Cattolica del Rio Grande do Sul, San Paulo, Brasile.
Objective:
To study the uterine mucosa of women with breast cancer in order to evaluate the frequency of endometrial diseases.
Experimental Design:
Prospective, controlled study carried out from January to December 1996. SURROUNDINGS: Patients with breast cancer and normal controls from 4 out-patient university services in Porto Alegre, Brazil.
Patients:
Postmenopausal women without hormonal therapy were compared: 67 of them with breast cancer and 101 normal controls.
Methods:
Hysteroscopy followed by endometrial biopsy carried out in both groups as an out-patient procedure.
Results:
In patients with breast cancer, 29.85% abnormal biopsies were found as follows: 10 endometrial polyps (15.0%), 8 with proliferative changes (11.9%), 1 case of cancer (1.5%), and one case of hyperplasia (1.5%). In the control group 8% abnormal morphological findings were found, as follows: 4 (4%) with endometrial polyps and 4 (4%) with proliferative changes. The differences in abnormal biopsies were statistically significant, mainly in patients with corporal mass index above 27.3. The sensibility of hysteroscopy was 82.14%; its specificity 97.16%; its predictive positive value 85.18% and its predictive negative value 96.48% in detecting endometrial activity, for a prevalence of 16.7% of endometrial activity.
Conclusions:
Endometrial evaluation must be included in the initial evaluation of patients with breast cancer, mainly if they were obese. Hysteroscopy, performed in out-patient basis, showed to be an adequate method to evaluate the uterine mucosa, helping to select the area of this cavity for biopsy.