Hysteroscopic dynamic assessment of the endometrium in patients treated with long-term tamoxifen

Tirso Pérez-Medina, Tirso Pérez‐Medina, F. Javier Salazar, Francisco J Salazar, Luis San-Frutos, Luis Sanfrutos, Mar Ríos, Jesús S. Jiménez López, Jesús S Jiménez, Juan Troyano, E. Cayuela, Enrique Cayuela, Enrique Iglesias
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 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.

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MeSH descriptors

Antineoplastic Agents, Hormonal Breast Neoplasms Endometrium Hysteroscopy Tamoxifen Aged Aged, 80 and over Analysis of Variance Antineoplastic Agents, Hormonal Antineoplastic Agents, Hormonal Atrophy Breast Neoplasms Breast Neoplasms Chemotherapy, Adjuvant Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometrium Endometrium Female

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