Ultrasonographic Appearance of the Uterine Endometrium in Sudanese Breast Cancer Women on Tamoxifen Therapy

Abstract

Although the potential benefit of Tamoxifen treatment in breast cancer patients outweighs its risk; however, all patients receiving Tamoxifen should undergo regular gynecologic evaluations. To survey the endometrial abnormality (endometrial thicknesses of 8 mm and more) using Trans-vaginal Ultrasound (TVS), data was collected prospectively from 104 patients with histologically confirmed stage I or II breast carcinoma, on Tamoxifen therapy for at least 6 months duration at Radiation and Isotopes Centre in Khartoum (RICK), Sudan during the period of June 2013 through December 2013. Means and proportions were compared between those with normal and abnormal endometrial thickness using student and chi-square test, respectively. P < 0.05 was considered significant. The mean (SD) duration of Tamoxifen use was 22 months. Among the total patients 39 (37.5%), 29 (27.8%), 20 (19.3%) and 16 (15.4%) used Tamoxifen for < 24, 24-36, 36-48 and ≥ 48 months respectively. Normal TVS was observed in 45 patients and abnormal findings were reported in 59 patients. In this study abnormal endometrial thickness was noticed more among nulliparous (p ≤ 0.001), longer duration of Tamoxifen use (p ≤ 0.001), premenopausal status (p ≤ 0.001), smoking (p ≤ 0.024) and BMI (p ≤ 0.001). In Conclusion: Although the discussions about endometrial screening in patients receiving Tamoxifen are still controversial, our study revealed strong association between Tamoxifen therapy and endometrial abnormality.