Abstract

INTRODUCTION: The aim of the study was to demonstrate the histopathological and ultrasonographic changes of endometrial tissue due to the tamoxifen use and to evaluate the affect of hypertension, obesity and diabetes mellitus on endometrial alteration. METHODS: One hundred and twenty eight patients who were administered tamoxifen at Training and Research Hospital between 2007-2012 were included to the study. Patients were checked annually with transvaginal ultrasonography underwent endometrial sampling in case of endometrial thickness > 5 mm and/or uterine bleeding. RESULTS: The mean time of tamoxifen treatment and the mean endometrial thickness were 4,43 years and 17,83 mm respectively at patients with endometrial cancer. Whenever compared with those cases without malignancy, the mean time of tamoxifen treatment and the mean endometrial thickness is 2,72 years and 9,3 mm respectively. The specificity and the sensitivity of transvaginal ultrasonography at detecting endometrial pathologies are 76.5% and 88,3% respectively when cut-off value of endometrial thickness was accepted as 8,5 mm. When the cut-off value was accepted 9,5 mm, the sensitivity decreased to 83,3% and specificity increased to 82,4%. DISCUSSION AND CONCLUSION: tamoxifen precipitates the development of endometrium cancer markedly in the patients with hypertension and diabetes mellitus. The increased duration of tamoxifen use is directly proportional with increasing risk of endometrial cancer. In patients with these risk factors, the sonographic follow-up criteria of endometrial thickness cut-off value should be accepted as 8,5 mm to obtain better result with higher sensitivity and specificity.

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