Tamoxifen, a selective estrogen receptor modulator (SERM), is used for adjuvant therapy in breast cancer (BC). However, it can also act as a proestrogen agonist in a low estradiol environment. The agonist properties affect the endometrium in more than half of the treated patients. Ultrasound screening is the leading non-invasive method for the primary diagnosis of the state of the endometrium in patients receiving single anti-estrogen therapy in peri- and postmenopause.

The objective. To improve management of patients receiving tamoxifen with analysis of types of echogram in gray scale, Doppler sonogram, 3D angiography and endometrial biopsy.

MATERIAL AND METHODS

Repeated pelvic ultrasound examinations were performed in 119 patients with breast cancer stages I—II, of which 56 patients (age 43—50 years) were in perimenopause and 63 (age 48—73 years) were postmenopausal and received anti-estrogen therapy only. All patients underwent endometrial biopsy.

RESULTS AND DISCUSSION

Ultrasound data on the state of the endometrium in patients with stage I—II breast cancer receiving anti-estrogen therapy were analyzed. The capabilities of ultrasound imaging in the differential diagnosis of endometrial hyperplastic and atrophic processes were evaluated. Four types of sonograms have been identified. The main difficulties in interpreting ultrasound data on the background of anti-estrogen therapy are indicated. Pathologic examination of endometrial tissue was performed in all patients.

CONCLUSIONS

The tactics of managing patients depending on the data of ultrasound examination was determined. A group of patients requiring invasive intervention (with an M-echo of more than 12 mm and the presence of subendometrial blood flow) and a follow-up group (with an M-echo of no more than 12 mm) were established.