Document Type : Original Research Article

Authors

• Tahereh Ashrafganjoei ¹
• nooshin amjadi ²
• Robabeh Taheripanah ³
• Hamed talayeh ⁴
• maryam Talayeh ⁵
• Nasim Noorinasab ⁶

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

² Associate Professor of Perinatology. Preventative Gynecology Research Center, Department of Obstetrics and Gynecology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

³ Associate Professor of Infertility, Department of Obstetrics and Gynecology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

⁴ Resident of Anesthesiology, Velayat medical center, Qazvin University of Medical Sciences, Qazvin, Iran.

⁵ Assistant Professor of Gynecology Oncology. Preventative Gynecology Research Center, Department of Obstetrics and Gynecology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

⁶ Obstetric and Gynecologist, 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

• vaginal bleeding
• tamoxifen
• breast cancer
• ultrasonography

Main Subjects

• Gynecology Oncology