Mehmet Anıl ONAN, Haldun GÜNER, Mehmet Fırat MUTLU, Tünay EFETÜRK

Meme kanseri olan hastalarda yapılan endometrial örnekleme sonrası elde edilen histopatolojik sonuçlar: 5 Yıllık deneyim

Amaç: Meme Kanseri tanısı konulmuş hastalarda çeşitli endikasyonlarlayapılan endometrial örneklemelerin histopatolojik sonuçlarının dağılımınıdeğerlendirmek ve bu sonuçların ultrasonla ölçülen endometrial kalınlıklakorelasyonunu saptamak.Yöntemler: Gazi Üniversitesi Hastanesi Kadın Hastalıkları ve Doğum Kliniğinebaşvuran, meme kanseri tanısıyla takip edilen hastaların endometrialörnekleme sonuçları retrospektif olarak değerlendirilmiştir. Değerlendirmeyedahil edilen hastalar daha önce tamoksifen kullanan ve kullanmayan,semptomatik olan ve olmayan (anormal uterin kanaması olan), ayrıcamenopozal olan ve olmayan olmak üzere sınıflandırılmıştır. Örnekleme öncesiultrasonografi bulguları kaydedilmiştir. Bulgular: Meme kanserli 106 hastanın %71.7'si örnekleme sırasında tamoksifen kullanmaktaydı. Tamoksifen kullanan ve kullanmayan hastaların endometrial histopatolojik sonuçları ve endometrial kalınlık ölçüsü arasında anlamlı fark saptanmamıştır. Tamoksifen kullanıcılarında düşük sensitivite ve spesifiteye rağmen endometrial kalınlık eşik değeri 9,45mm olarak saptanmıştır. Premenopozal ve postmenopozal hastaların endometrial kalınlık ve histopatolojik sonuçları arasında anlamlı fark saptanmamıştır. Sonuç: Endometrium kanseri açısından ek bir risk faktörü bulunmadığı sürece, takipte meme kanseri olan veya tamoksifen kullanan hastaların yıllık rutin kontrollere dahil edilmesi ve semptomatik olmaları halinde endometrial örnekleme yapılması önerilmektedir. Endometrial kalınlık eşik değerinin duyarlılığının düşük olması nedeniyle, örnekleme endikasyonu salt ultrasonografi bulgularıyla konulmamalıdır. Meme kanseriyle eşlik eden endometrium kanseri açısından klinisyenin duyarlı olması ve tamoksifenin 5 yıldan fazla kullanılmaması önerilmelidir.

The histopathological results of endometrial samples taken from breast cancer patients: A five-year experience

Objective: To evaluate the histopatologic results of endometrial samples taken from patients with known breast cancer. A correlation between different pathologic results and ultrasonographically measured endometrial stripe thickness was sought. Methods: Patients with breast cancer applying to Gazi University Hospital and had undergone endometrial sampling for various indications were included and their histopatological results were retrospectively analyzed.patients were categorized into subgroups according to use of tamoxifen, being symptomatic or not (i.e.abnormal bleeding) and their menopausal status. In all cases the patients' endometrial thickness was ultrasonographically measured and noted prior sampling. Results: Out of 106 patients with prior diagnosis of breast cancer, 71.7% were receiving tamoxifen adjuvant therapy at the time of sampling.There was unsignificant difference between histopathological results and endometrial thickness between patients using tamoxifen and those not. Despite low sensitivity and specificity a cut-off endometrial thickness value of 9.45mm was reached in tamoxifen users. The difference between endometrial thickness and histopathological results in the premenopausal and postmenopausal groups was not significant. Conclusion: Given that a paitent with breast cancer has no other risk factors for endometrial cancer, they should be followed up on a routine annual basis and be informed to apply to a hospital in the event of abnormal uterine bleeding. In such a case endometrial sampling should be undertaken.Since endometrial thickness has a low sensitivity in predicting negative histopathological results, it should not be used the sole indication for endometrial sampling. physicians should be familiar with endometrial pathologies coinciding breast cancer and should not allow extended use of tamoxifen for over 5 years.

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