选择性雌激素受体调节剂对绝经后乳腺癌患者子宫内膜的影响

目的 探讨应用选择性雌激素受体调节剂(SERM)的绝经后乳腺癌患者子宫内膜病变相关因素及筛查方法.方法 分析上海市长宁区妇幼保健院2013年1月至2020年6月间84例口服SERM的绝经后乳腺癌患者因经阴道超声(TVS)发现子宫内膜增厚行宫腔镜下子宫内膜活检术患者的临床资料.结果 宫腔镜术前有13例(15.5％)患者有...

Effect of selective estrogen receptor modulator on endometrium in postmenopausal patients with breast cancer

Objective To explore the related factors and screening methods of endometrial lesions in postmenopausal breast cancer patients with selective estrogen receptor modulator(SERM).Methods The clinical data of 84 postmenopausal breast cancer patients who received oral SERM treatment in Maternal and Child Health Hospital of Changning District of Shanghai City from January 2013 to June 2020 and suffered from endometrial thickening found by transvaginal ultrasonography(TVS)and underwent hysteroscopic endometrial biopsy was retrospectively analyzed.Results Before hysteroscopy,13 cases(15.5%)had vaginal bleeding symptoms,71 cases(84.5%)had no clinical symptoms.The pathological examination results after hysteroscopy showed that there were 11 cases of endometrial atypical hyperplasia/malignant lesions,and TVS before the operation showed that the thickness of the endometrium was 17.0±11.5 mm,which was significantly higher than that of other pathological groups(P<0.05).If preoperative TVS indicated that the endometrium was≥13 mm,the specificity for the diagnosis of endometrial atypical hyperplasia/malignant lesions was 93.2%,and the sensitivity was 81.8%.Logistic regression analysis showed that preoperative TVS suggested endometrial thickness and postmenopausal vaginal bleeding were high risk factors for endometrial atypical hyperplasia/malignant lesions.Conclusion Increased endometrial thickness and postmenopausal vaginal bleeding are high risk factors for endometrial atypical hyperplasia/malignant lesions.TVS is still the preferred screening method for postmenopausal breast cancer patients with SERM.