{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T13:00:00Z","timestamp":1793451600955,"version":"4.5.0"},"reference-count":48,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2000,10,20]]},"abstract":"<jats:p> PURPOSE: To study the value of transvaginal ultrasound (TVS) in endometrial screening of postmenopausal breast cancer patients treated with tamoxifen. <\/jats:p><jats:p> PATIENTS AND METHODS: In 247 tamoxifen-treated (20 to 30 mg\/d for \u2265 2 years) women and 98 controls, the endometrium was prospectively followed-up by means of TVS every 6 months for up to 5 years. Patients with homogeneous endometrium of more than 10-mm thickness were then scanned repeatedly every 3 months. <\/jats:p><jats:p> RESULTS: The mean endometrial thickness was 3.5 \u00b1 1.1 mm before treatment and increased to a maximum of 9.2 \u00b1 5.1 mm after 3 years of tamoxifen application (P &lt; .0001), which was significantly (P &lt; .0001) thicker compared with controls. Fifty-two asymptomatic patients with thickened or morphologically suspect endometrium underwent hysteroscopy and dilatation and curettage (D&amp;C), resulting in four uterine perforations. Histopathologically, atrophy was found in 38 patients (73.1%), polyps in nine, hyperplasia in four, and endometrial cancer in one case. In 20 screened patients who reported vaginal bleeding, five atrophies (25%), five polyps, four hyperplasias, and two endometrial cancers were found. Before hysteroscopy and D&amp;C were performed, 36 (69.2%) of 52 asymptomatic and four (20%) of 20 symptomatic patients were scanned by repeated TVS over 2 to 30 months. Invasive diagnostic procedures were significantly (P &lt; .05) more frequent in younger and obese patients. In the controls, one asymptomatic polyp and one symptomatic hyperplasia were found. <\/jats:p><jats:p> CONCLUSION: In tamoxifen-treated patients, TVS offered a high false-positive rate, even with a cutoff value of 10 mm for endometrial thickness and repeated TVS scans. Increased iatrogenic morbidity and only one asymptomatic endometrial carcinoma do not warrant endometrial screening by TVS in tamoxifen-treated patients. <\/jats:p>","DOI":"10.1200\/jco.2000.18.20.3464","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T09:03:48Z","timestamp":1487927028000},"page":"3464-3470","source":"Crossref","is-referenced-by-count":156,"title":["Effects of Adjuvant Tamoxifen on the Endometrium in Postmenopausal Women With Breast Cancer: A Prospective Long-Term Study Using Transvaginal Ultrasound"],"prefix":"10.1200","volume":"18","author":[{"given":"Bernd","family":"Gerber","sequence":"first","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Department of Pathology, and Institute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Krause","sequence":"additional","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Department of Pathology, and Institute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiner","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Department of Pathology, and Institute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toralf","family":"Reimer","sequence":"additional","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Department of Pathology, and Institute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"K\u00fclz","sequence":"additional","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Department of Pathology, and Institute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Makovitzky","sequence":"additional","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Department of Pathology, and Institute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guenter","family":"Kundt","sequence":"additional","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Department of Pathology, and Institute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Friese","sequence":"additional","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Department of Pathology, and Institute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1-0468","unstructured":"Buzdar  AU,   Hortobagyi  GN:   Recent advances in adjuvant therapy of breast cancer.   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