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Re: PMB & Tamoxifen From: art fougner, md (evsono@pipeline.com) Thu Jan 20 06:11:53 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: OB: Macrosomia" Previous message: Elrod Darryl G MAJ 48 MDOS/SGOBO: "Mono-di twins" In reply to: Joanne Bulley, MD: "PMB & Tamoxifen" Next in thread: Joanne Bulley, MD: "Re: PMB & Tamoxifen" Reply: Joanne Bulley, MD: "Re: PMB & Tamoxifen" Joanne this goes back to my suggestion of SIS in the evaluation of abnormal bleeding. Am J Obstet Gynecol. 1994 Feb;170(2):447-51. Related Articles, Links Comment in: * Am J Obstet Gynecol. 1995 Feb;172(2 Pt 1):717-8. * Am J Obstet Gynecol. 1995 Mar;172(3):1067-8. Click here to read Unusual ultrasonographic appearance of the uterus in patients receiving tamoxifen. Goldstein SR. New York University School of Medicine, Department of Obstetrics and Gynecology, NY. Tamoxifen is widely used as adjunctive therapy for patients with breast cancer and has been suggested as protection against the development of breast cancer in women at risk on the basis of heredity. It is a nonsteroidal estrogen antagonist, but like all antagonists it has some agonistic properties. Its administration should result in atrophic changes in the endometrium, but paradoxically some reports have found hyperplasia and even carcinomas developing prospectively in patients on tamoxifen therapy. Increasingly, endovaginal ultrasonography is being used for endometrial assessment in a wide variety of patients. This report is the first description of an unusual ultrasonographic finding in the uteri of some patients receiving tamoxifen. Initially believed to be endometrial in location, when viewed after fluid instillation (sonohysterogram) the heterogenous bizarre ultrasonographic appearance was actually found to represent small subendometrial sonolucencies in the proximal myometrium. Because none of these patients were clinically bleeding and all had inactive endometria on biopsy, it seems prudent not to overinterpret ultrasonography findings in patients receiving tamoxifen who have not had fluid-enhanced assessment. art At Wed, 19 Jan 2005, Joanne Bulley, MD wrote: > >50 yo G2 with breast cancer on Tamoxifen for 3 years. (was on OCPs for >birth control up to time of diagnosis) > >PMB (post menopausal bleeding) in December: office pipelle -- no tissue. >Ultrasound (US) in early January -- 13mm inhomogeneous endometrial >stripe > >Hysteroscopy with D&C a week later -- no visible abmormalities at all >and no endometrial tissue obtained on curettage (despite very vigorous >curetting as I could see that I wasn't getting anything) > >1. I figure there is no pathology and she can continue on the Tamoxifen >2. WHY does the US show "inhomogeneous endometrial stripe of 13 mm"? > >-- >Joanne Bulley, MD >Keene, NH, USA > >"They who would give up an essential liberty for temporary security, >deserve neither liberty nor security." -- Benjamin Franklin > >"Without debate, without criticism, no administration and no country can >succeed -- and no republic can survive." -- John F. Kennedy > -- art fougner, md "If you don't know where you are going, you will wind up somewhere else." Lawrence Peter Berra Next message: DoctorJoe@aol.com: "Re: OB: Macrosomia" Previous message: Elrod Darryl G MAJ 48 MDOS/SGOBO: "Mono-di twins" In reply to: Joanne Bulley, MD: "PMB & Tamoxifen" Next in thread: Joanne Bulley, MD: "Re: PMB & Tamoxifen" Reply: Joanne Bulley, MD: "Re: PMB & Tamoxifen"

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