Paraclinical Findings in Patients with Breast Cancer under Tamoxifen Treatment Suffering from Abnormal Vaginal Bleeding

Background & Objective: 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.Materials & 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 ۱۰۰ patients with a mean age of ۵۶.۲ ± ۲.۹ years and a mean endometrial thickness of ۱۴.۵ ± ۳.۴ mm. Notably, ۲۵% of the patients exhibited abnormally large uterine size. Ultrasonography revealed polyps and myomas in ۳۶% and ۱۵% of cases, respectively. Positive hysteroscopy findings were observed in ۷۲%, comprising polyps in ۳۶%, hyperplasia in ۳۲%, and atrophy in ۴%. Pathological assessment identified abnormal features in ۳۱% as polyps, ۳۴% as hyperplasia, ۴% as atrophy, and ۵% 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:

Ultrasonography , Hysteroscopy , Breast neoplasms , Uterine Hemorrhage , tamoxifen