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  #1  
Old 03-04-2013
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ObGyn Screening for Uterine Cancer!

55 yr old Caucasian woman comes to see you in office for follow up. She has a history of breast cancer in left breast 2 yrs ago for which she underwent mastectomy. Her cancer was estrogen receptor positive and she was started on tamoxifen. pt has recently found that tamoxifen can cause uterine cancer. Which of the following is the surveillance strategy for uterine cancer in pt on tamoxifen?

A. Careful history and annual pap smear
B. Transvaginal ultrasound for endometrial thickness
C. Annual ct scan pelvis for endometrial hyperplasia
D. Annual endometrial biopsy
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  #2  
Old 03-04-2013
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Arrow B

B or D,
but I guess B is a correct answer.
Trans-vaginal saline infusion ultrasound.
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Old 03-04-2013
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Default A



Careful History and Pap smear....if pap smear shows glandular cells e.g. ASGUS not ASCUS.....then proceed with B
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Old 03-04-2013
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nothing useful except biopsy , but ther are no recommendations for annul uterine biopsies . pap is for cervical CA surveillance
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Old 03-04-2013
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Default Biopsy not recommended in Tamoxifen use!

Quote:
Originally Posted by dr mumble View Post
nothing useful except biopsy , but ther are no recommendations for annul uterine biopsies . pap is for cervical CA surveillance
There is no recommendation for Biopsy as a screening tool for women on tamoxifen...the only strategy is history and pap smear...u can await qurats response!
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Old 03-04-2013
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Quote:
Originally Posted by stfidel View Post
There is no recommendation for Biopsy as a screening tool for women on tamoxifen...the only strategy is history and pap smear...u can await qurats response!
saying the same , at this time you will screen for cervial CA( age related surveillance ) no need to do uterine screening untill suspicion . but when suspicious screening with boipsy
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  #7  
Old 03-05-2013
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yes the ans is A but thats the confusing part that pap smear is for cervical cancer n i think its explained that we do regular check up n pap smear until pt show some symptoms....
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