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Follow-up in patients on tamoxifen


Authors: as. MUDr. Jiří Bouda, Ph.D. 1;  MUDr. Jiří Štěpán 1;  MUDr. Tomáš Svoboda 2;  doc. MUDr. Zdeněk Rokyta, CSc. 1
Authors‘ workplace: Gynekologicko-porodnická klinika LF UK a FN Plzeň 1;  radioterapeutické oddělení FN Plzeň 2
Published in: Prakt Gyn 2006; 10(2): 60-63

Overview

Tamoxifen is the most frequently used drug in hormonal treatment of breast cancer. Follow-up of patients on tamoxifen is controversial and it has no universal guidelines. We analyze a group of 74 patients on tamoxifen indicated for hysteroscopy for abnormal ultrasonography (USG; 71.6%), abnormal uterine bleeding (AUB; 6.8%), abnormal USG and AUB (10.8%), or other indications (10.8%). Histological examination revealed four times (5.4%) simple non-atypical hyperplasia, six times (8.1%) endometrial polyp with simple non-atypical hyperplasia, and one time (1.4%) well differentiated endometroid endometrial carcinoma, other findings (85.1%) were atrophic, proliferative, and secretory endometrium or atrophic endometrial polyp. Ultrasound was not significant for endometrial pathology. 46% patients with AUB had clinically relevant endometrial pathology comparing to 11.5% clinically relevant pathologies in asymptomatic patients. We show a high rate of false positivity of USG and the importance of AUB as a symptom of endometrial pathology in our patient series. The examination at the beginning of the treatment and its dynamic changes during follow-up are important. USG is a basic diagnostic method of follow-up, hysteroscopy is the best diagnostic and therapeutical method for any endometrial pathology.

Key words:
breast cancer – tamoxifen – hormonal treatment – ultrasonography – hysteroscopy


Sources

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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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