L'isteroscopia nella identificazione e nel monitoraggio delle alterazioni endometriali nel trattamento ormonale adiuvante del carcinoma mammario

The incidence of breast cancer continues to increase and it represents one of the leading causes of death in females. For several decades tamoxifen has been the most widely used drug in adjuvant hormone therapy for such neoplasia, recently substituted in many cases by aromatase inhibitors. The potential adverse effects these drugs can cause at uterine level entail the need to use simple and effective strategies for the monitoring, diagnosing and treating of such pathologies. Notwithstanding the valid contribution of the transvaginal ultrasonography in evaluating endouterine alterations, changes induced by these drugs at endometrial level in such patients can cause, in many cases, considerable difficulties of interpretation and diagnosis. The use of hysteroscopy is confirmed as an indispensable and often decisive support in the timely and definitive diagnosis of endometrial pathologies, of their monitoring and treatment. In the present work endouterine alterations found at the hysteroscopy in 209 patients with advanced mammary neoplasia, who have undergone post-surgical adjuvant treatment with tamoxifen and aromatase inhibitors are analyzed, with particular concern to the comparison between ultrasound scan evaluation and hysteroscopy in the diagnostic approach, in the treatment and in the follow-up.