Next steps after uterine lining thickening

Gemini4 -- I just had an endometrial biopsy last week.  I had uterine thickening, but then also had two longer periods in August and October (hadn't had a period November last year just after I started on tamoxifen.)

I wasn't given a choice to do a D&C, but not sure I would have gone that route anyway. 

Have you had that kind of biopsy before?  I hadn't and wasn't prepared for how much it hurt -- not meaning to scare you and the pain only lasted while they were doing it, but if I had known about the pain, I think I would have popped a Tylenol or two before the procedure

Sounds like you are well prepared -- I ended up going in for a consult and we did the biopsy at that appointment -- I'm going to make note of the cervix dilation med in case there is a next time!

I've had biopsies & they aren't bad. I wait until I have bleeding to go into see the GYN. He suggested I start coming in sooner(every 6 months). I was waiting until the spotting turned to bleeding & I needed to wear a small tampon. Then it's time for the hysteroscopy/D&C & I always have a polyp that needs to go.

While tamoxifen has an anti-oestrogen effect on breast cells, it has a pro-oestrogen effect on endometrial cells. That means that while it will help prevent breast cancer recurrence, it may cause endometrial changes. This is a known, and well-documented side effect of tamoxifen. Endometrial changes can include thickening, polyps and - very rarely - endometrial cancer, which is why regular screening is a good idea while taking tamoxifen just to keep an eye on things. Your OB/GYN is being careful and meticulous, but it doesn't necessarily mean that something sinister is happening.

chknfeet- the hysteroscopy is a way of viewing the inside of the uterus. Perhaps your gyn will "biopsy" or remove anything found that is abnormal. There is a procedure I sometimes get. It's call a hydrosonogram. Fluid is instilled into the uterus & it pushes the uterine walls outward. Then they do an ultrasound. It's good for picking up polyps.

Sometimes I get a "biopsy" where a thin (whirly-gig) catheter is inserted into my uterus & the specimen is obtained. For the thickened lining, I've been getting a D&C at the same time my polyps are removed.

I've got just under 2years left on tamoxifen(I'm stopping at 5). I'll probably really slip into menopause sometime soon. Switching to an AI seems like I would just be trading problems. My BS's $.02, is that it would be a bad choice for me because I'm "so active". She said there are 80yr olds on tamoxifen. Now, my MO, was willing to just call me menopausal without any blood work & switch me to an AI. I told him I wasn't comfortable with that because of family history of late menopause & I had a period less than a year ago on tamoxifen.sigh

I have been warned about the thickening effects of my lining due toTamoxifen by both my OBGYN and my Oncologist. Due to my BRCA-2 diagnosis and the fact that I have had breast cancer twice I have started to have pelvic ultrasounds every 6 months. I am now 42 years old but the first time I took Tamoxifen I was 29. I did not notice near as many effects the first time around on Tamoxifen but this time I have developed ovarian cysts and also a cervical polyp. I am not sure if it is because I am older now or why I am having more issues this time. I just keep in close contact with my OBGYN and am expecting some weird reactions at this point. Best of luck to you!

Hi Jayne! Welcome to Breastcancer.org. We just wanted to welcome you to Breastcancer.org, and let you know that we're so glad you've found our community, and we hope you find the support and advice you need here.

Best,

The Mods

Hi! Happy to find this discussion! In March I will have been on TMX for 7 yrs!! At 5 yrs my Onc and I decided to continue due to new research, and I had two friends that stopped at 5 and ended up with recurrences... So, I stuck to it. For no apparent reason I did have my first trans.vag.ultrasound last month. The lining of my uterus measured just over the normal range. Didn't get a #. Doc called it "Low-high". I'm 48 and my cycles have been erratic for the last 2 yrs, but I still have about 5 periods a year. So, AI is not an option. There was a time when I thought I'd be on TMX forever, but now with this slight issue of my lining, I'm considering stopping this summer. I'm going to have another ultrasound in March and will discuss biopsy then. Reading all of your posts reassures me that the result will be good news. Obviously, my next topic for my Onc will be stopping TMX. I've been trying to find info on what side effects may be like when STOPPING TMX. Only finding info about effects of taking it. Won't we go thru some kind of "withdrawal"? I do currently suffer from hip/joint pain, jaw line break outs, erratic sex drive and the random hot flash. But these are all things that could easily be attributed to getting older and being perimenopausal. Anyone notice any big changes after stopping tmx?

hsmac - I was on Tamoxifen for 5 years (the first time) and had no side effects or issues when I stopped taking it

mammalou- what kind of follow-up will you be having? My experience is that my lining only got thicker, caused bleeding & polyp formation. This ultimately led to D&Cs. If you can't get answers out of your current GYN, will your insurance allow you to see a gynecological oncologist?

JoTro..good luck tomorrow!

Somewhat off topic … are you all seeing a gynecologist who specializes in woman w/a history/high risk for cancer? I haven't even begun to search and it never crossed my mind that there are specialists out there. I saw my regular gyno just shortly after stopping chemo (routine/annual) and she seemed very laissez faire about the whole cancer dx and possible impacts of going on Tamox. I want to find someone who will take it seriously and be more proactive than reactive.