ABSTRACT
OBJECTIVE: To investigate the clinicopathological effects of taking tamoxifen(TAM)on endometrium after breast cancer operation.METHODS: From January 2011 to December 2017,622 cases of breast cancer were treated in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Among them,197 patients took TAM,and 59 patients who took TAM underwent hysteroscopic surgery due to abnormal vaginal bleeding or ultrasound endometrial abnormalities.The 59 patients were divided into premenopausal and postmenopausal groups to analyze the pathological condition;the medication time was defined as 3 years and 5 years,so as to observe the endometrial pathology.Set the endometrial abnormal hyperplasia includes: endometrial cancer and the endometrial atypical hyperplasia, and the rest are benign endometrial lesions and the normal endometrium, and then analyze the ultrasound criteria for abnormal endometrial thickening in premenopausal and postmenopausal according to the endometrial pathology.RESULTS: Among the 197 patients who took TAM after breast cancer,59 patients underwent hysteroscopic surgery,32.2%(19/59)of them visited the hospital because of abnormal vaginal bleeding,76.3%(45/59)were pathologically confirmed to have a lesion,in which the endometrial polyps was with the highest incidence.The incidence of endometrial cancer after menopause was 20.0%(6/30),premenopausal endometrial cancer 3.4%(1/29),and atypical hyperplasia before menopause was 20.7%(6/29).When taking TAM for more than 3 or 5 years,the incidence of endometrial cancer and atypical hyperplasia increased.Premenopausal ultrasound endometrial thickness is associated with abnormal endometrial hyperplasia(P=0.035).The endometrial thickness 15 mm can be used as the best diagnostic ultrasound cut-off for the diagnosis of premenopausal abnormal endometrial thickening. Postmenopausal ultrasound endometrial thickness was not associated with abnormal endometrial hyperplasia(P=0.631).CONCLUSION: Taking TAM after breast cancer surgery can result in endometrial polyps and endometrial hyperplasia.Premenopausal patients can also have endometrial cancer and atypical hyperplasia,so the endometrial monitoring should not be ignored.Those who take TAM for more than 3 years need to be more alert to the occurrence of endometrial lesions.The premenopausal B-ultrasound endometrial thickness 15 mm can be used as the best diagnostic ultrasound cut-off for the diagnosis of abnormal endometrial thickening. After the menopause, the endometrial thickness of 5 mm was still used as the standard for abnormal endometrial thickening.