Obstet Gynecol Sci.  2017 Jan;60(1):26-31. 10.5468/ogs.2017.60.1.26.

Endometrial polyp surveillance in premenopausal breast cancer patients using tamoxifen

Affiliations
  • 1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea. marialeemd@gmail.com

Abstract


OBJECTIVE
To describe the endometrial pathologic lesions in premenopausal breast cancer patients with a history of tamoxifen (TMX) use.
METHODS
We retrospectively reviewed the medical records of 120 premenopausal breast cancer patients with a history of TMX use that had undergone a gynecological examination.
RESULTS
Among 120 patients, 44.2% (n=53) were asymptomatic with an endometrial thickness ≥5 mm, as assessed by transvaginal ultrasonography. Of the patients that reported abnormal uterine bleeding, 5% (n=6) had an endometrial thickness <5 mm and 20% (n=24) had an endometrial thickness ≥5 mm by transvaginal ultrasonography. The final group of patients were asymptomatic, but showed an abnormal endometrial lesion, such as an endometrial polyp, by transvaginal ultrasonography (30.8%, n=37). Of the 56 benign lesions that were histologically reviewed, 50 (41.7%) were endometrial polyps, 3 (2.5%) were submucosal myomas, 2 (1.7%) were endometrial hyperplasias, and 1 (0.8%) was chronic endometritis. There were 64 (53.3%) other non-pathologic conditions, including secreting, proliferative, and atrophic endometrium, or in some cases, there was insufficient material for diagnosis. In our data, only one case was reported as a complex hyperplasia without atypia arising from an endometrial polyp, and one patient was diagnosed with endometrioid adenocarcinoma.
CONCLUSION
For premenopausal breast cancer patients with a history of TMX use, the majority of the patients were asymptomatic, and endometrial polyps were the most common endometrial pathology observed. Therefore, we believe that endometrial assessment before starting TMX treatment, and regular endometrial screening throughout TMX treatment, are reasonable suggestions for premenopausal breast cancer patients.

Keyword

Breast neoplasms; Endometrial polyps; Hysteroscopy; Premenopausal; Tamoxifen

MeSH Terms

Breast Neoplasms*
Breast*
Carcinoma, Endometrioid
Diagnosis
Endometrial Hyperplasia
Endometritis
Endometrium
Female
Gynecological Examination
Humans
Hyperplasia
Hysteroscopy
Mass Screening
Medical Records
Myoma
Pathology
Polyps*
Retrospective Studies
Tamoxifen*
Ultrasonography
Uterine Hemorrhage
Tamoxifen

Cited by  1 articles

Risk Factors Associated with Endometrial Pathology in Premenopausal Breast Cancer Patients Treated with Tamoxifen
Maria Lee, Jinlan Piao, Myung Jae Jeon
Yonsei Med J. 2020;61(4):317-322.    doi: 10.3349/ymj.2020.61.4.317.


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