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Re: Tamoxifen/long term follow up From: J. Hellriegel (jhellrie@pce.net) Wed Apr 16 16:03:33 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Domenico: "Helps for Immunological infertility" Previous message: rbraun@indyunix.iupui.edu: "Re: Can you top this??" In reply to: Garry E. Siegel, M.D.: "Tamoxifen/long term follow up" At Tue, 15 Apr 1997, Garry E. Siegel, M.D. wrote: > >I have a patient who is 6 years out from Breast Cancer, postmenopausal, >who in 1994, while on Tamoxifen, developed postmenopausal bleeding, with >a 21 mm endometrium labeled as suspicious for neoplasia by the >radiologist (she moved from out of town with that report and films). >Because my office biopsy was unsuccessful (scant tissue), she had a >hysteroscopy and D and C with more polyps than I've ever seen, like a >molar pregnancy, read as complex hyperplasia without atypia. She >subsequently was placed on Megace 20 mg. day 1 - 12, and is off >Tamoxifen as it now has been 5 years, and about 2.5 since her D and C. I >have followed her every 6 to 12 months with ultrasounds and biopsies, >which have been stable. She has not bled in some time. > >I plan to follow her with ultrasound only, and not biopsy, since I don't >think I get a good sample (I just get a little polypoid stuff with >difficulty). > >What do ya'll think? Should I stop the Megace? Continue to scan and/or >biopsy? > >Garry -- I think that it would be safe to stop the Megace and follow her with US only if she is not obese. However, I would do the following: -- I would cycle her every three or four months with a progestin. If no bleeding for one year, I would then stop the progestin cycling. -- J. Hellriegel, Jr., MD, PhD Next message: Domenico: "Helps for Immunological infertility" Previous message: rbraun@indyunix.iupui.edu: "Re: Can you top this??" In reply to: Garry E. Siegel, M.D.: "Tamoxifen/long term follow up"

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