Hysteroscopic evaluation of the endometrium in postmenopausal women taking tamoxifen

Study Objective. To evaluate hysteroscopic endometrial changes due to tamoxifen therapy in postmenopausal women with breast cancer. Design, Retrospective study (Canadian Task Force classification II-2). Setting. University-affiliated hospital. Patients. Eighty-eight postmenopausal women (or with iatrogenic amenorrhea) receiving tamoxifen 20 mg/day for at least 7 year for breast cancer. Intervention. Record review of patients undergoing transvaginal sonography (TVS) and office hysteroscopy with eye-directed biopsy specimens obtained with a 5-mm, continuous-Flow operative hysteroscope. Measurements and Main Results, Patients with thickened endometrium and pathologic findings at hysteroscopy had taken tamoxifen for significantly longer times than those without such findings (p < 0.05). Conclusion. Our findings confirm the estrogenic effect of tamoxifen on endometrium. Endometrial evaluation by TVS suggests further diagnostic procedures, but only hysteroscopy allows the surgeon to Visualize endometrial lesions and obtain eye-directed biopsy tissue.