Follow-up in patients on tamoxifen

Česká verzia

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

Summary

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

Zdroje

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