The clinic-pathology of gynecological complications in 134 cases of breast cancer

Objective To analyze the clinic-pathology characteristics of gynecological complications in 134 women with breast cancer, and to explore the relationship between these characteristics and postoperative management of Tamoxifen (TAM).Methods The clinic-pathological features of 90 patients taken postoperative TAM and 44 without TAM were analyzed retrospectively. Results Different main complain was observed in the two groups: TAM group was the abnormalities detected by B sonography (68.9%), while vaginal irregular bleeding or the changes of menstruation in the control group (31.8%,P0.05). Endometrial polyps were found in 25.6% of the TAM group whereas 9.1% of the control group (P0.05). More endometrial hyperplasia was diagnosed in TAM group than in the control group, 30.0% vs. 13.6%, P0.05. The TAM group and the contral group developed endometrial carcinoma at ratio of 1∶3. More TAM group had uterus myoma or adenomyosis than the control, 66.2% vs. 44.1%, P0.05. No significant difference between the two groups was observed on the pathology of cervix and ovary. The most common pathological changes were chronic cervicitis (82.8%), and functional ovarian cysts (34.2%). The incidences of endometrial polyps and cervical polyps increased as the TAM taken time increased (P0.05), while the incidences of uterus myoma or myoma degeneration was not related to the TAM taken time (P0.05). TAH+BSO was conducted in 68.9% of the TAM group and 61.4% of the control group. The therapy by IUD was 10.0% and 2.3% in the two groups, respectively. Conclusions The incidences of endometrial diseases and uterus myoma or adenomyosis in the patients with breast cancer receiving Tamoxifen are increased. And the endometrial diseases are positively related to the TAM taken time. All breast cancer patients should be closely and routinely checked up by transvaginal sonography or hysteroscopy, and receive effective and less invasive therapy.