Re: Tamoxifem & Mirena
From: art fougner, md (evsono@pipeline.com)
Sat Oct 29 19:05:11 2005
I've found that quite a few of these patients have pathology, mostly
polyps. However, few patients have pre-treatment sonograms. One group
of investigators who looked at this found that many patients had those
polyps present BEFORE starting Tamoxifen, suggesting consideration of
baseline TVS.
Art
At Sat, 29 Oct 2005, Peter Wein wrote:
>
>We have found the same - the thickening seen on ultrasound seems to
>really be a subendometrial cystic change, with the overlying endometrium
>being bland.
>
>--
>Peter Wein
>
>Atkinson, Samuel M wrote:
>
>>Endometrial cancer is reported with long term Tamox but I have done many
>>biopsies for the increaded endometriums on Tamox and they are invariably
>>neg. At D&C there is no endometrium at all. I think, but obv cannot
>>prove that Tamox causes an US pix of thickened endomet that is really a
>>fibrosed thickened myometrium that gives a false positive report. Thus
>>I now stop with a negative Pipelle. Certainly agree with the Mirena
>>unless you know she is PM for sure (like an FSH). Pf course 1.12 is not
>>excessive for a menstruating woman!.
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne
>>Bulley, MD
>>Sent: Thursday, October 27, 2005 5:19 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Tamoxifem & Mirena
>>
>>50yo G2P2 Breast CA 2000 (because I insisted she have her mammograms in
>>'99 & '00 - she tried to argue her way out).
>>
>>Treated with excision / sentinel nodes and radiation therapy. Followed
>>by 5 years Tamoxifen which was completed 9/00.
>>
>>Mirena placed for contraception 08/04.
>>
>>Erratic bleeding during the summer.
>>
>>US done (because of Tamoxifen even though most likely benign
>>peri-menopausal bleed with Progesterone IUD)
>>
>>US IUD in place. Some fibroid change. Endometrium 1.12 cm. Ovaries
>>Fine.
>>
>>Thoughts, anyone?
>>
>>--
>>Joanne Bulley, MD
>>Keene, NH, USA
>>
>>"Love is indescribable and unconditional.
>>I could tell you a thousand things that it is not, but not one that it
>>is."
>>- Duke Ellington, American jazz artist (1899-1974).
>>
--
art fougner, md
"I knew I was going to take the wrong train, so I left early."
Lawrence Peter Berra
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