Iranian Society of Gynecology Oncology

Document Type : Original Research Article

Authors

1 Department of Obstetrics and Gynecology, Preventative Gynecology Research Center (PGRC), Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Resident of Anesthesiology, Velayat Medical Center, Qazvin University of Medical Sciences, Qazvin, Iran

3 Department of Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Iran.

Abstract

Introduction: The administration of tamoxifen to post-menopausal patients with breast cancer may lead to vaginal bleeding, necessitating a thorough understanding of associated factors. Our objective was to investigate sonographic, hysteroscopic, and pathologic findings in breast cancer patients experiencing vaginal bleeding following tamoxifen use.
Methods: In this cross-sectional study, we evaluated women with post-menopausal breast cancer reporting vaginal bleeding while undergoing tamoxifen treatment for more than six months. Data collection involved a checklist encompassing ultrasonographic, hysteroscopic, and pathologic findings.
Results: The study included 100 patients with a mean age of 56.2 ± 2.9 years and a mean endometrial thickness of 14.5 ± 3.4 mm. Notably, 25% of the patients exhibited abnormally large uterine size. Ultrasonography revealed polyps and myomas in 36% and 15% of cases, respectively. Positive hysteroscopy findings were observed in 72%, comprising polyps in 36%, hyperplasia in 32%, and atrophy in 4%. Pathological assessment identified abnormal features in 31% as polyps, 34% as hyperplasia, 4% as atrophy, and 5% as cancerous lesions.
Conclusion:  Patients who received tamoxifen had high endometrial thickness due to endometrial polyp, it seems that clinicians can consider using hysteroscopy with dilation and curettage in these patients. 

Keywords

Main Subjects

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