Prospective endometrial assessment of breast cancer patients treated with third generation aromatase inhibitors.

Objective: A prospective evaluation of the effects on endometrium of third generation aromatase inhibitors (AIs), administered as adjuvant up-front therapy or switched therapy in menopausal patients suffering from breast cancer.

Methods: Forty-five patients suffering from estrogen-receptor positive breast cancer were treated with AIs as adjuvant endocrine therapy; 27 patients switched from tamoxifen to AIs (group 1) due to adverse medical events related to tamoxifen intake (22 patients) or to an extended endocrine treatment after 60 months of tamoxifen therapy (5 patients); whereas 18 patients received AIs as up-front adjuvant therapy (group 2). All patients underwent endometrial investigation before the start of AIs therapy and, thereafter, at 12 month intervals.

Histopathologic behavior of endometrial hyperplasia during tamoxifen therapy for breast cancer.

Objective: The purpose of the present study is to prospectively evaluate the effects of tamoxifen on the pathological behavior of endometrial hyperplasias without atypia, diagnosed before the start of adjuvant endocrine therapy, in menopausal patients suffering from breast cancer.

Methods: Twenty-six patients suffering from estrogen-receptor positive breast cancer and candidate to receive adjuvant tamoxifen, were found to be affected by endometrial hyperplasias before the start of endocrine therapy. All women showed a baseline endometrial stripe, measured by transvaginal ultrasonography, thicker than 4 mm and the diagnosis of endometrial hyperplasia was made by hysteroscopy and endometrial biopsy.

Accuracy of hysteroscopic diagnosis of endometrial hyperplasia: a retrospective study of 323 patients.

Study Objective: To evaluate the diagnostic accuracy of hysteroscopic view in endometrial hyperplasia.

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Public hospital in northern Italy.

Baseline endometrial assessment before tamoxifen for breast cancer in asymptomatic menopausal women.

Objective: The aim of this study is to estimate the prevalence of endometrial pathology before the start of tamoxifen therapy in menopausal breast cancer patients.

Methods: Ninety-one gynecologically asymptomatic patients, suffering from estrogen receptor-positive breast cancer and scheduled for adjuvant tamoxifen, underwent pretreatment endometrial assessment. In all patients, a transvaginal ultrasonography was carried out; a double-layered endometrial stripe measuring above 4 mm was considered as abnormal.

Outpatient hysteroscopic polypectomy in 237 patients: feasibility of a one-stop "see-and-treat" procedure.

Study Objective: To evaluate the feasibility of a "see-and-treat" office polyp resection, using a 5-mm sheathed operative hysteroscope.

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Public hospital.

Hysteroscopically targeted biopsies compared with blind samplings in endometrial assessment of menopausal women taking tamoxifen for breast cancer.

Study Objective: To determine the validity of tissue sampling accomplished by hysteroscopically targeted or blind biopsies in the assessment of endometrial morbidity associated with tamoxifen treatment.

Design: Retrospective, unrandomized study (Canadian Task Force classification II-2).

Setting: Public hospital.

Saline infusion sonography and office hysteroscopy to assess endometrial morbidity associated with tamoxifen intake.

Objective: The objective of this study was to compare office feasibility, patient acceptance, and diagnostic accuracy of hysteroscopy (HYS) and saline infusion sonography (SIS) in breast cancer patients taking tamoxifen.

Methods: Sixty-six asymptomatic postmenopausal women on tamoxifen for breast cancer underwent SIS, followed by outpatient HYS with endometrial biopsy. In all women an endometrial stripe over 4 mm was previously measured by transvaginal ultrasonography (TU).

Hysteroscopic assessment of menopausal breast-cancer patients taking tamoxifen; there is a bias from the mode of endometrial sampling in estimating endometrial morbidity?

The aim of this study is to evaluate the accuracy of hysteroscopy in detecting tamoxifen-associated endometrial morbidity. Ninety-eight menopausal breast cancer patients taking tamoxifen underwent hysteroscopy because of an endometrial thickness above 4mm measured by Transvaginal Ultrasonography. Thirty-one women recorded uterine bleeding while 67 were asymptomatic.