Abstract:

INTRODUCTION: To evaluate the endometrialchanges between asymptomatic postmenopausalwomen with breast cancer using tamoxifen or aromatase inhibitors. METHODS: Asymptomatic postmenopausal patients with breast cancer who were on tamoxifen or arimidex therapy for more than six months were enrolled for the study. Twenty two women had been on tamoxifen and jorty women had been on arimidex. Routine gynecologic exam was performed for all patients. Transvaginal ultrasonography, saline injusion sonography and bilateral uterine artery doppler sonography were performed for all patients. Later endometrial biopsy was applied to all patients with pipelle canula. RESULTS: The percentage oj endometrial jormations, sonography findings were compared between the two groups. Endometrial polip was detected in 3 patients who were on tamoxifen (13,5%) and 6 patients who were on arimidex (15%). The sensitivity of transvaginal ultrasonography was jound to be 33% with a specificity of 90% when the cut-off level for endometrial thickness was set as 8,5 mm. When the cut-off level during saline injusion sonography was set as 7,7 mm the sensitivity was 33% and the specificity was 92%. DISCUSSION AND CONCLUSION: For our group of patients endometrial thickening was found to be higher in tamoxifen group when compared with the aromatase inhibitors group. Doppler sonography showed no predictive value for any endometrial pathology. Ultrasonography should be performed for screening, saline infusion sonography should be applied for any detected sonographic pathology bejare invasive diagnostic tests.

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