Abstract
Background and aim: Adenomyosis is a uterine disease defined by the presence and growth of endometrial or endometrial-like structures within the myometrium. Imaging, including transvaginal ultrasound (TVUS), or magnetic resonance (MRI), is used to non-invasively diagnose adenomyosis. The condition is normally identified in reproductive life, but it can also be detected in postmenopausal women. Due to the fact that tamoxifen treatment is usually prolonged in breast cancer (BC) patients as an adjuvant endocrine therapy, and considering the association between tamoxifen and the increased incidence of endometrial pathologies, the present study investigated the possible association of long treatment tamoxifen with imaging signs (TVUS and MRI) of adenomyosis.
Methods: The study group consisted of BC patients (n=25) without clinical or imaging signs of uterine disorders prior to the tamoxifen treatment. Patients were followed up for a period of 6 to 60 months during which TVUS was performed for the evaluation of endometrial thickness and, because of the identification of abnormal uterine imaging findings. An MRI examination was also performed.
Results: During follow up, TVUS evidenced diffuse (40%) or internal cystic (32%) adenomyosis among the BC patients treated with tamoxifen, which was confirmed by MRI, with some difference in the phenotype, showing mainly internal cystic adenomyosis (80%).
Conclusions: The present data suggests that in some BC patients undergoing tamoxifen treatment, imaging follow-up with TVUS showing abnormal uterine findings further assessed by MRI may be useful in identifying adenomyosis.
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Copyright (c) 2025 Silvia Gabbrielli, Dilruba Tureli, Icro Meattini, Silvia Vannuccini, Angela Gallone, Kubra Ozpinar, Milo Giani, Massimiliano Fambrini, Vittorio Miele, Felice Petraglia