Ultrasonography of the endometrium and endometrial pathology under tamoxifen treatment.

PURPOSE: The estrogenic effects of tamoxifen on the endometrium and the vaginal epithelium are evaluated.

METHOD: 211 postmenopausal women were examined (tamoxifen group: 176 estrogen-receptor positive breast cancer patients; control group I: 35 estrogen-receptor negative breast cancer patients; control group II: 50 women without breast cancer taking no hormones). We determined the endometrial thickness and the maturation index (MI). Person's chi-square-test and the t-test for independent samples were used.

RESULTS

In the tamoxifen group, the mean endometrial thickness and the MI were significantly higher (p<0.0001) than in the control groups. No evidence of correlation in duration of tamoxifen intake and endometrial thickness was found (Pearson's correlation coefficient: 0.4773; p=0.0001). The maturation index significantly (p<0.0001) increased under tamoxifen therapy. There was no correlation in the maturation index and endometrial thickness (Pearson's correlation coefficient: 0.1649; p=0.169). The histological clarification (N=47; endometrial thickness greater than 8 mm) revealed 3 neoplasms, 9 endometrial polyps, 2 glandular-cystic hyperplasias and in 32 cases atrophic endometrium.

CONCLUSION

An apparent increase of endometrial thickness and the maturation of the vaginal epithelium caused by the estrogenic effect of tamoxifen was demonstrated.