Hysteroscopic Dynamic Assessment of the Endometrium in Patients Treated with Long-Term Tamoxifen

Tirso Pérez‐Medina, F. Javier Salazar, Luis Sanfrutos, Mar Ríos, Jesús S. Jiménez López, Juan Troyano, E. Cayuela, Enrique Iglesias
In: Journal of Minimally Invasive Gynecology · 2011 · vol. 18(3) , pp. 349–354 · doi:10.1016/j.jmig.2010.12.014 · PMID:21411378 · W2087727610
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This study explored hysteroscopic visualization of the endometrium in patients receiving long-term tamoxifen treatment.

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Abstract

Study objectiveTo describe the evolutive endometrial hysteroscopic patterns in patients undergoing long-term tamoxifen treatment.DesignProspective analysis. Analysis of variance test with post hoc Bonferroni test and homogeneity test of percentages were used for hypothesis contrast between the groups.Design classificationCanadian task force II-2.SettingFour Spanish tertiary care hospitals.PatientsA total of 278 patients with breast cancer diagnosed between 2002 and 2004, which completed 5-years adjuvant therapy with tamoxifen.InterventionsUltrasonography and hysteroscopic explorations were performed before starting the treatment and then at yearly intervals during the 5 years of adjuvant treatment.Measurements and main resultsHysteroscopic 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.ConclusionTamoxifen produces five different endometrial patterns that evolve dynamically throughout the 5 years of treatment.

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