Endometrial hyperplasia thickens the uterus lining that causes heavy or abnormal bleeding. It raises the risk of endometrial cancer and uterine cancer. It is a common side effect of Tamoxifen after Breast Cancer.
A Endometrial Hyperplasia Case Report By Dr. Sangeeta Agrawal
I will discuss a common side effect of Tamoxifen with the example of a case report.
I would like to share this because this could be relevant to many women.
Tamoxifen is commonly given to prevent the recurrence of breast cancer.
Tamoxifen is the oldest and most-prescribed selective estrogen receptor modulator (SERM). It is used in women and men diagnosed with hormone-receptor-positive, breast cancer to reduce the risk of cancer coming back (recurring).
Why is Tamoxifen Given?
• It reduces the risk of recurrence of breast cancer by 40% to 50% in postmenopausal women and by 30% to 50% in premenopausal women.
• It reduces the risk of new cancer developing in the other breast by about 50%.
• Preoperatively to shrink large, hormone-receptor-positive breast cancers before surgery.
• Slow or stop the growth or advanced (metastatic) hormone-receptor-positive breast cancer.
Endometrial Hyperplasia Case Report
Our patient was a 58-year-old woman, menopausal for 10 years, mother of one child who is now 30 years of age.
Six years ago she was discovered to have breast cancer and she underwent surgery and was doing well.
She has been on tamoxifen for the last two years.
She started complaining of bleeding from the vagina for the last two months and therefore was advised to do sonography of the pelvis.
On sonography, the endometrial lining was very thick 15 millimeters and there was fluid inside.
This is a common side effect of the medication because tamoxifen has oestrogen like effect on the endometrium and therefore the endometrium can start generating again. It can also cause bleeding and this becomes a cause for concern in menopausal women.
She was advised to see a gynaecologist and that is how she came to us.
When she came to us we have done a routine clinical examination and then on the basis of the sonography, she was advised to undergo a Diagnostic hysteroscopy and dilatation and curettage under anaesthesia.
This involves taking her to the operation theatre, giving her anaesthesia, and looking inside the uterus with a telescope.
We saw that she had an endometrial polyp and this was removed. There was minimal endometrial lining which was collected and sent for histological examination along with the polyp. She recovered well from the procedure which took only 30 minutes and she was discharged on the same day.
The Histology revealed that there were no cancerous changes, only atrophic endometrium, and polyp.
She was then referred back to the oncologist who advised her to continue the tamoxifen safely for another year.
So if you are on Tamoxifen and have any irregular abnormal vaginal bleeding, then please speak to your doctor.
Consult Dr. Sangeeta Agrawal for Endometriosis Hyperplasia
