Endometrial changes in breast cancer patients treated with Tamoxifen. Role of ultrasound in its various forms. Experience at the Instituto Nacional de Cancerologia, Mexico

Background: Determine the role of ultrasound in the diagnosis of endometrial pathology induced by tamoxifen in women with a history of breast cancer, using the measurement of the endometrium and morphological changes. Establish the most frequent injury-induced endometrial tamoxifen. Materials and methods: Were reviewed retrospectively and descriptive pelvic ultrasound, transvaginal, sonohysterography and electronic files of 52 patients treated with tamoxifen in the Instituto Nacional de Cancerologia. Primary endpoint considered that endometrial thickness was measured in the anteroposterior diameter standard regarding measuring 5 mm or less. The endometrial thickness was correlated with the presence or absence of symptoms, duration of treatment, morphological changes, histopathological findings and their association with risk endometrial disease (polyps, hyperplasia and cancer). Results: The median age of patients was 52.25 years, range more often at presentation was 4145 years and 56-60 years. Thirty five examinations (82.6%) of patients had endometrial thickness of 10 mm being the most frequent. The most frequent pathological findings by ultrasound was the presence of cystic areas with a p=0.05, endometrial polyps (28.8%), atrophy (17.3%), liquid in endometrial cavity (23.1%), myoma (19.2%). The most common endometrial lesions confirmed by pathology: endometrial polyps (50%), endometrial hyperplasia without atypia (36%), atrophy (9%), endometrial carcinoma (5%). Conclusion: The ultrasound showed a high sensitivity and specificity for detection of incipient lesions at risk of malignant transformation and endometrial cancer. Asymptomatic patients after 5 years of treatment with tamoxifen also develop lesions using ultrasound can be detected early, without having to wait for symptoms. Treatment with tamoxifen for more than 5 years have highest risk of Endometrial Carcinoma. The endometrial thickness and the presence of cystic areas are early indicators of altered endometrial conditioned by tamoxifen.