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Tamoxifen-induced Uterine Abnormalities: The Role of Imaging¹

¹ From the Departments of Radiology (S.M.A., I.I.) and Pathology (J.M.L.), Georgetown University Medical Center, 3800 Reservoir Rd, NW, Washington, DC 20007-2197 (S.M.A., I.I.), and the Department of Radiology, Shimane Medical University, Japan (I.I.). Received September 22, 1998; revision requested, November 4; revision received, March 2, 1999; accepted July 28. Address reprint requests to S.M.A. (e-mail: aschers@gunet.georgetown.edu).

Abstract

Tamoxifen citrate is an orally administered, nonsteroidal antiestrogen agent that is widely used for the treatment of breast cancer and that has recently been found to prevent breast cancer in some high-risk populations. Tamoxifen may, however, cause adverse effects at the uterine level. In this article, the authors review (a) the histopathologic uterine changes associated with tamoxifen therapy, (b) the spectrum of uterine imaging findings in women treated with tamoxifen, and (c) the recommendations of the American College of Obstetrics and Gynecology for women treated with tamoxifen. An algorithm for imaging evaluation of the uterus in women treated with tamoxifen is presented.

Index terms: Leiomyoma, 854.315 • Magnetic resonance (MR), comparative studies, 854.121411, 854.121412, 854.12143 • State of the Art • Tamoxifen • Ultrasound (US), comparative studies, 854.12981, 854.12983, 854.12988, 854.12989 • Uterine neoplasms, 854.32 • Uterus, abnormalities, 854.1495, 854.64 • Uterus, cysts, 854.311 • Uterus, MR, 854.121411, 854.121412, 854.12143 • Uterus, US, 854.12981, 854.12983, 854.12988, 854.12989

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