Fiorino Marello - Academia.edu (original) (raw)

Papers by Fiorino Marello

Research paper thumbnail of Outpatient hysteroscopy by vaginoscopic approach

Journal of The American Association of Gynecologic Laparoscopists, Aug 1, 2001

Research paper thumbnail of Mother to infant transmission of HCV: a 24 months prospective study in infants born to HIV negative mothers

Journal of Pediatric Gastroenterology and Nutrition, 2000

Research paper thumbnail of Ipotiroidismo in gravidanza: nostra esperienza

"Medicina Perinatale 98", VII Congresso Nazionale della Società Italiana di Medicina Perinatale, 1998

Research paper thumbnail of Ambulatory Hysteroscopic Surgery with 5 Fr. Bipolar Device: Technical Aspects, Indications and Limits

Research paper thumbnail of Office Hysteroscopy Diagnostic Accuracy. Comparison Between Hysteroscopic and Hysterectomy Findings

Research paper thumbnail of Mother to infant transmission of HCV: a 24 months prospective study in infants born to HIV negative mothers

Journal of Pediatric Gastroenterology and Nutrition, 2000

Research paper thumbnail of Valutazione isteroscopica nelle donne in menopausa candidate alla terapia ormonale sostitutiva

Research paper thumbnail of Vertical Transmission of Hepatitis C Virus in a Cohort of 2,447 HIV-Seronegative Pregnant Women: A 24-Month Prospective Study

Journal of Pediatric Gastroenterology and Nutrition, 2001

Research paper thumbnail of Outpatient hysteroscopy by vaginoscopic approach

The Journal of the American Association of Gynecologic Laparoscopists, 2001

Research paper thumbnail of Diagnosis of a mullerian anomaly by vaginoscopic approach

The Journal of the American Association of Gynecologic Laparoscopists, 2004

of more than 1 year postsurgery, 39 patients (55.7%) became pregnant. The comparison between the ... more of more than 1 year postsurgery, 39 patients (55.7%) became pregnant. The comparison between the pregnant group and nonpregnant group, a significantly low value (p =.0457) was shown only for the age of the pregnant patients; however no significant difference was shown for period of infertility, number of enucleated myoma, maximum enucleated myoma diameter, or the weight of enucleated objects. Investigation by age bracket showed that 28 of 42 subjects aged 34 or younger (66.6%) were pregnant, and that 11 of 28 subjects aged 35 or older (39.3%) were pregnant. A significant difference (p =.023) was seen between these two groups. Conclusion. Laparoscopic myomectomy is a useful tech

Research paper thumbnail of Office hysteroscopy: Pain evaluation by visual analog scale

The Journal of the American Association of Gynecologic Laparoscopists, 2004

Research paper thumbnail of Hysteroscopic evaluation of the endometrium in postmenopausal women taking tamoxifen

The Journal of the American Association of Gynecologic Laparoscopists, 2000

To evaluate hysteroscopic endometrial changes due to tamoxifen therapy in postmenopausal women wi... more To evaluate hysteroscopic endometrial changes due to tamoxifen therapy in postmenopausal women with breast cancer. Retrospective study (Canadian Task Force classification II-2). University-affiliated hospital. Patients. Eighty-eight postmenopausal women (or with iatrogenic amenorrhea) receiving tamoxifen 20 mg/day for at least 1 year for breast cancer. Record review of patients undergoing transvaginal sonography (TVS) and office hysteroscopy with eye-directed biopsy specimens obtained with a 5-mm, continuous-flow, operative hysteroscope. Patients with thickened endometrium and pathologic findings at hysteroscopy had taken tamoxifen for significantly longer times than those without such findings (p < 0.05). Our findings confirm the estrogenic effect of tamoxifen on endometrium. Endometrial evaluation by TVS suggests further diagnostic procedures, but only hysteroscopy allows the surgeon to visualize endometrial lesions and obtain eye-directed biopsy tissue.

Research paper thumbnail of Office treatment of large endometrial polyps using the versaPoint bipolar device

The Journal of the American Association of Gynecologic Laparoscopists, 1999

Objective. To evaluate endometrial modifications in postmenopausal women with breast cancer takin... more Objective. To evaluate endometrial modifications in postmenopausal women with breast cancer taking tamoxifen. Measurements and Main Results. Eighty-eight postmenopausal women (age 37-81 yrs) underwent TVUS and office hysteroscopy with eye-directed biopsies using a 5-ram continuous-flow operative office hysteroscope. Eighteen patients had received tarnoxifen for less than 12 months (range 4-11 too, group 1) and 70 for at least 12 months (range 12-72 mo, group 2). Transvaginal ultrasound revealed endometrial thickness greater than 5 mm in 62 women in group 1 and 7 in group 2. In group 1, hysteroscopy revealed 2 endometrial polyps, and in group 2 it found 26 endometrial polyps, 9 cases of endometrial hyperplasia, and 4 areas of focal adenocarcinoma. Twelve women in group 2 complained of abnormal uterine bleeding, whereas all patients in group 1 were asymptomatic. Conclusion. These data confirm the estrogenic effect of tamoxifen on endometrium. Endometrial evaluation by TVUS can suggest further diagnostic procedures (i.e., sonohysterography) but only hysteroscopy allows visualization of lesions and eye-directed biopsies.

Research paper thumbnail of Hysteroscopic endometrial evaluation in postmenopausal women taking tamoxifen for breast cancer

The Journal of the American Association of Gynecologic Laparoscopists, 1999

Objective. To evaluate endometrial modifications in postmenopausal women with breast cancer takin... more Objective. To evaluate endometrial modifications in postmenopausal women with breast cancer taking tamoxifen. Measurements and Main Results. Eighty-eight postmenopausal women (age 37-81 yrs) underwent TVUS and office hysteroscopy with eye-directed biopsies using a 5-ram continuous-flow operative office hysteroscope. Eighteen patients had received tarnoxifen for less than 12 months (range 4-11 too, group 1) and 70 for at least 12 months (range 12-72 mo, group 2). Transvaginal ultrasound revealed endometrial thickness greater than 5 mm in 62 women in group 1 and 7 in group 2. In group 1, hysteroscopy revealed 2 endometrial polyps, and in group 2 it found 26 endometrial polyps, 9 cases of endometrial hyperplasia, and 4 areas of focal adenocarcinoma. Twelve women in group 2 complained of abnormal uterine bleeding, whereas all patients in group 1 were asymptomatic. Conclusion. These data confirm the estrogenic effect of tamoxifen on endometrium. Endometrial evaluation by TVUS can suggest further diagnostic procedures (i.e., sonohysterography) but only hysteroscopy allows visualization of lesions and eye-directed biopsies.

Research paper thumbnail of Hysteroscopic evaluation of menopausal patients with sonographically atrophic endometrium

The Journal of the American Association of Gynecologic Laparoscopists, 1999

Objective. To report that certain endometriotic pelvic lesions remain symptomatic after complete ... more Objective. To report that certain endometriotic pelvic lesions remain symptomatic after complete healing. Measurements and Main Results. One hundred sixty women (age 22-48 yrs, number of operations for those symptoms 0-8, number of lesions 2-6) underwent laparoscopy because of chronic pelvic pain and/or infertility for 6 months to 10 years. Laparoscopic appearance of lesions was white, opacified, focal peritoneal structures, usually with vascular conversions, and with or without puckering or circular peritoneal defects. Excision was pertbrmed with biopsy forceps to elevate the lesion, followed by wide peritoneal lining incision using endoshears, with or without bipolar coagulation for hemostasis. This was followed by isolating the lesion completely with blunt and sharp dissection until removed. Specimens in 64 women (40%) were both positive and negative for endometriosis, and in 96 (60%) they were all negative. Some lesions showed evidence of healing, such as fibrosis, mesothelial hyperplasia, inclusion cysts, and chronic inflammation, but were negative for endometriosis. One patient developed inguinal abscess 5 days postoperatively and required incisional drainage. Follow-up ranged from 3 months to 4 years. Eleven women (6.8%) failed to improve despite postoperative leuprolide acetate therapy for 6 months, and required another laparoscopic excision; the remaining 149 improved dramatically by 6 weeks. Five patients with long history of symptoms required 6 months for full recovery. Conclusion. Endometriotic lesions that heal with medical treatment, electrocoagulation, or spontaneously can continue to cause symptoms; thus complete excision could relieve symptoms.

Research paper thumbnail of Hysteroscopic evaluation of menopausal women with endometrial thickness of 4 mm or greater

The Journal of the American Association of Gynecologic Laparoscopists, 1999

Study Objective. To assess the diagnostic and operative potential of hysteroscopy in postmenopaus... more Study Objective. To assess the diagnostic and operative potential of hysteroscopy in postmenopausal patients .selected by ultrasound criteria. Design. Cohort study (Canadian Task Force classification 11-2). Setting. Outpatient ultrasound and hysteroscopy department of a university-affiliated hospital. Patients. One hundred fifty-five postmenopausa/ women with endometrial thickness of 4 mm or more by ultrasound, in menopause for at least 1 year, with or without menopausal complaints. Nnterventions. Transvaginal ultrasound and office hysteroscopy with eye-directed biopsy specimens using a 5-ram, continuous-flow, operative hysteroscope. Measurements and Main Results. Of the 155 women, 129 (83%) were asymptomatic (irregular bleeding). Hysteroscopy showed endometrial pathology in 28% of asymptomatic patients (23 polyps, 5 cases of hyperplasia, 8 submucous myomata) and 76% of symptomatic women (13 polyps, 6 hyperplasia, 1 submucous myoma). Hysteroscopic results compared with histologic diagnosis showed a positive predictive value equal to 97. 1% and 95% in asymptomatic and symptomatic women, respectively, and a negative predictive value equal to 100% in both groups. Conclusion. Office hysteroscopy with endometrial biopsy samples has a diagnostic and operative role in postmenopausal patients selected based on endometrial thickness on ultrasound, in view of the high prevalence of endometrial pathology in both symptomatic and asymptomatic women.

Research paper thumbnail of High rate of spontaneous viral clearance in a cohort of vertically infected hepatitis C virus infants: what lies behind?

Journal of Hepatology, 2001

Research paper thumbnail of Diagnostic inadequacy of dilatation and curettage

Fertility and Sterility, 2001

To assess the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic fin... more To assess the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings with this technique with those obtained after hysterectomy. Design: Retrospective clinical study. Setting: University-affiliated hospital. Patient(s): Three hundred ninety-seven patients with abnormal uterine bleeding who underwent D&C and, within 2 months, hysterectomy because of histologic findings or persistence of symptoms. Main Outcome Measure(s): Comparison of histologic findings on D&C with those obtained after hysterectomy. Result(s): In 248 of 397 patients (62.5%), D&C failed to detect intrauterine disorders subsequently found at hysterectomy; the sensitivity was 46%, the specificity was 100.0%, the positive predictive value was 100.0%, and the negative predictive value was 7.1%. Conclusion(s): Dilatation and curettage is an inadequate diagnostic and therapeutic tool for all uterine disorders; this technique missed 62.5% of major intrauterine disorders, and all endometrial disorders were still present in the removed uterus.

Research paper thumbnail of Endometrial damage by antiestrogens in a postmenopausal breast cancer patient

Acta Obstetricia et Gynecologica Scandinavica, 2002

Research paper thumbnail of Sonographic, hysteroscopic, and histologic evaluation of the endometrium in postmenopausal women with breast cancer receiving tamoxifen

The Journal of the American Association of Gynecologic Laparoscopists, 2000

To evaluate the estrogenic effects of tamoxifen on the endometrium in postmenopausal women with b... more To evaluate the estrogenic effects of tamoxifen on the endometrium in postmenopausal women with breast cancer. Consecutive study (Canadian Task Force classification II-2). University-affiliated hospital. Thirty-three women. Interventions. All patients underwent transvaginal sonography (TVS) and color flow Doppler of endometrial vessels, hysteroscopy, and, if necessary, endometrial biopsy or other operative hysteroscopic procedures. In four women the endometrium was thin on TVS and atrophic at hysteroscopic assessment. In 29 women with thick endometrium on TVS, hysteroscopy and endometrial biopsy showed atrophy (11 patients), hyperplasia (5), polyps (11), and well-differentiated adenocarcinoma (2). The two endometrial cancers were present in women with uterine bleeding. In women with positive histologic findings, the endometrium was significantly thicker (p = 0.04) and duration of tamoxifen therapy longer than in those with negative findings, although this was not statistically significant (p = 0.067). We believe regular assessment of the endometrium by TVS should be performed in postmenopausal patients at the start of the tamoxifen therapy, and hysteroscopy in women with a thick endometrium or postmenopausal bleeding. We believe that patients with thin endometrium on TVS at the beginning of tamoxifen therapy, who have no abnormal uterine bleeding should be screened with these examinations for 2 years.

Research paper thumbnail of Outpatient hysteroscopy by vaginoscopic approach

Journal of The American Association of Gynecologic Laparoscopists, Aug 1, 2001

Research paper thumbnail of Mother to infant transmission of HCV: a 24 months prospective study in infants born to HIV negative mothers

Journal of Pediatric Gastroenterology and Nutrition, 2000

Research paper thumbnail of Ipotiroidismo in gravidanza: nostra esperienza

"Medicina Perinatale 98", VII Congresso Nazionale della Società Italiana di Medicina Perinatale, 1998

Research paper thumbnail of Ambulatory Hysteroscopic Surgery with 5 Fr. Bipolar Device: Technical Aspects, Indications and Limits

Research paper thumbnail of Office Hysteroscopy Diagnostic Accuracy. Comparison Between Hysteroscopic and Hysterectomy Findings

Research paper thumbnail of Mother to infant transmission of HCV: a 24 months prospective study in infants born to HIV negative mothers

Journal of Pediatric Gastroenterology and Nutrition, 2000

Research paper thumbnail of Valutazione isteroscopica nelle donne in menopausa candidate alla terapia ormonale sostitutiva

Research paper thumbnail of Vertical Transmission of Hepatitis C Virus in a Cohort of 2,447 HIV-Seronegative Pregnant Women: A 24-Month Prospective Study

Journal of Pediatric Gastroenterology and Nutrition, 2001

Research paper thumbnail of Outpatient hysteroscopy by vaginoscopic approach

The Journal of the American Association of Gynecologic Laparoscopists, 2001

Research paper thumbnail of Diagnosis of a mullerian anomaly by vaginoscopic approach

The Journal of the American Association of Gynecologic Laparoscopists, 2004

of more than 1 year postsurgery, 39 patients (55.7%) became pregnant. The comparison between the ... more of more than 1 year postsurgery, 39 patients (55.7%) became pregnant. The comparison between the pregnant group and nonpregnant group, a significantly low value (p =.0457) was shown only for the age of the pregnant patients; however no significant difference was shown for period of infertility, number of enucleated myoma, maximum enucleated myoma diameter, or the weight of enucleated objects. Investigation by age bracket showed that 28 of 42 subjects aged 34 or younger (66.6%) were pregnant, and that 11 of 28 subjects aged 35 or older (39.3%) were pregnant. A significant difference (p =.023) was seen between these two groups. Conclusion. Laparoscopic myomectomy is a useful tech

Research paper thumbnail of Office hysteroscopy: Pain evaluation by visual analog scale

The Journal of the American Association of Gynecologic Laparoscopists, 2004

Research paper thumbnail of Hysteroscopic evaluation of the endometrium in postmenopausal women taking tamoxifen

The Journal of the American Association of Gynecologic Laparoscopists, 2000

To evaluate hysteroscopic endometrial changes due to tamoxifen therapy in postmenopausal women wi... more To evaluate hysteroscopic endometrial changes due to tamoxifen therapy in postmenopausal women with breast cancer. Retrospective study (Canadian Task Force classification II-2). University-affiliated hospital. Patients. Eighty-eight postmenopausal women (or with iatrogenic amenorrhea) receiving tamoxifen 20 mg/day for at least 1 year for breast cancer. Record review of patients undergoing transvaginal sonography (TVS) and office hysteroscopy with eye-directed biopsy specimens obtained with a 5-mm, continuous-flow, operative hysteroscope. Patients with thickened endometrium and pathologic findings at hysteroscopy had taken tamoxifen for significantly longer times than those without such findings (p < 0.05). Our findings confirm the estrogenic effect of tamoxifen on endometrium. Endometrial evaluation by TVS suggests further diagnostic procedures, but only hysteroscopy allows the surgeon to visualize endometrial lesions and obtain eye-directed biopsy tissue.

Research paper thumbnail of Office treatment of large endometrial polyps using the versaPoint bipolar device

The Journal of the American Association of Gynecologic Laparoscopists, 1999

Objective. To evaluate endometrial modifications in postmenopausal women with breast cancer takin... more Objective. To evaluate endometrial modifications in postmenopausal women with breast cancer taking tamoxifen. Measurements and Main Results. Eighty-eight postmenopausal women (age 37-81 yrs) underwent TVUS and office hysteroscopy with eye-directed biopsies using a 5-ram continuous-flow operative office hysteroscope. Eighteen patients had received tarnoxifen for less than 12 months (range 4-11 too, group 1) and 70 for at least 12 months (range 12-72 mo, group 2). Transvaginal ultrasound revealed endometrial thickness greater than 5 mm in 62 women in group 1 and 7 in group 2. In group 1, hysteroscopy revealed 2 endometrial polyps, and in group 2 it found 26 endometrial polyps, 9 cases of endometrial hyperplasia, and 4 areas of focal adenocarcinoma. Twelve women in group 2 complained of abnormal uterine bleeding, whereas all patients in group 1 were asymptomatic. Conclusion. These data confirm the estrogenic effect of tamoxifen on endometrium. Endometrial evaluation by TVUS can suggest further diagnostic procedures (i.e., sonohysterography) but only hysteroscopy allows visualization of lesions and eye-directed biopsies.

Research paper thumbnail of Hysteroscopic endometrial evaluation in postmenopausal women taking tamoxifen for breast cancer

The Journal of the American Association of Gynecologic Laparoscopists, 1999

Objective. To evaluate endometrial modifications in postmenopausal women with breast cancer takin... more Objective. To evaluate endometrial modifications in postmenopausal women with breast cancer taking tamoxifen. Measurements and Main Results. Eighty-eight postmenopausal women (age 37-81 yrs) underwent TVUS and office hysteroscopy with eye-directed biopsies using a 5-ram continuous-flow operative office hysteroscope. Eighteen patients had received tarnoxifen for less than 12 months (range 4-11 too, group 1) and 70 for at least 12 months (range 12-72 mo, group 2). Transvaginal ultrasound revealed endometrial thickness greater than 5 mm in 62 women in group 1 and 7 in group 2. In group 1, hysteroscopy revealed 2 endometrial polyps, and in group 2 it found 26 endometrial polyps, 9 cases of endometrial hyperplasia, and 4 areas of focal adenocarcinoma. Twelve women in group 2 complained of abnormal uterine bleeding, whereas all patients in group 1 were asymptomatic. Conclusion. These data confirm the estrogenic effect of tamoxifen on endometrium. Endometrial evaluation by TVUS can suggest further diagnostic procedures (i.e., sonohysterography) but only hysteroscopy allows visualization of lesions and eye-directed biopsies.

Research paper thumbnail of Hysteroscopic evaluation of menopausal patients with sonographically atrophic endometrium

The Journal of the American Association of Gynecologic Laparoscopists, 1999

Objective. To report that certain endometriotic pelvic lesions remain symptomatic after complete ... more Objective. To report that certain endometriotic pelvic lesions remain symptomatic after complete healing. Measurements and Main Results. One hundred sixty women (age 22-48 yrs, number of operations for those symptoms 0-8, number of lesions 2-6) underwent laparoscopy because of chronic pelvic pain and/or infertility for 6 months to 10 years. Laparoscopic appearance of lesions was white, opacified, focal peritoneal structures, usually with vascular conversions, and with or without puckering or circular peritoneal defects. Excision was pertbrmed with biopsy forceps to elevate the lesion, followed by wide peritoneal lining incision using endoshears, with or without bipolar coagulation for hemostasis. This was followed by isolating the lesion completely with blunt and sharp dissection until removed. Specimens in 64 women (40%) were both positive and negative for endometriosis, and in 96 (60%) they were all negative. Some lesions showed evidence of healing, such as fibrosis, mesothelial hyperplasia, inclusion cysts, and chronic inflammation, but were negative for endometriosis. One patient developed inguinal abscess 5 days postoperatively and required incisional drainage. Follow-up ranged from 3 months to 4 years. Eleven women (6.8%) failed to improve despite postoperative leuprolide acetate therapy for 6 months, and required another laparoscopic excision; the remaining 149 improved dramatically by 6 weeks. Five patients with long history of symptoms required 6 months for full recovery. Conclusion. Endometriotic lesions that heal with medical treatment, electrocoagulation, or spontaneously can continue to cause symptoms; thus complete excision could relieve symptoms.

Research paper thumbnail of Hysteroscopic evaluation of menopausal women with endometrial thickness of 4 mm or greater

The Journal of the American Association of Gynecologic Laparoscopists, 1999

Study Objective. To assess the diagnostic and operative potential of hysteroscopy in postmenopaus... more Study Objective. To assess the diagnostic and operative potential of hysteroscopy in postmenopausal patients .selected by ultrasound criteria. Design. Cohort study (Canadian Task Force classification 11-2). Setting. Outpatient ultrasound and hysteroscopy department of a university-affiliated hospital. Patients. One hundred fifty-five postmenopausa/ women with endometrial thickness of 4 mm or more by ultrasound, in menopause for at least 1 year, with or without menopausal complaints. Nnterventions. Transvaginal ultrasound and office hysteroscopy with eye-directed biopsy specimens using a 5-ram, continuous-flow, operative hysteroscope. Measurements and Main Results. Of the 155 women, 129 (83%) were asymptomatic (irregular bleeding). Hysteroscopy showed endometrial pathology in 28% of asymptomatic patients (23 polyps, 5 cases of hyperplasia, 8 submucous myomata) and 76% of symptomatic women (13 polyps, 6 hyperplasia, 1 submucous myoma). Hysteroscopic results compared with histologic diagnosis showed a positive predictive value equal to 97. 1% and 95% in asymptomatic and symptomatic women, respectively, and a negative predictive value equal to 100% in both groups. Conclusion. Office hysteroscopy with endometrial biopsy samples has a diagnostic and operative role in postmenopausal patients selected based on endometrial thickness on ultrasound, in view of the high prevalence of endometrial pathology in both symptomatic and asymptomatic women.

Research paper thumbnail of High rate of spontaneous viral clearance in a cohort of vertically infected hepatitis C virus infants: what lies behind?

Journal of Hepatology, 2001

Research paper thumbnail of Diagnostic inadequacy of dilatation and curettage

Fertility and Sterility, 2001

To assess the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic fin... more To assess the diagnostic inadequacy of dilatation and curettage (D&C) by comparing histologic findings with this technique with those obtained after hysterectomy. Design: Retrospective clinical study. Setting: University-affiliated hospital. Patient(s): Three hundred ninety-seven patients with abnormal uterine bleeding who underwent D&C and, within 2 months, hysterectomy because of histologic findings or persistence of symptoms. Main Outcome Measure(s): Comparison of histologic findings on D&C with those obtained after hysterectomy. Result(s): In 248 of 397 patients (62.5%), D&C failed to detect intrauterine disorders subsequently found at hysterectomy; the sensitivity was 46%, the specificity was 100.0%, the positive predictive value was 100.0%, and the negative predictive value was 7.1%. Conclusion(s): Dilatation and curettage is an inadequate diagnostic and therapeutic tool for all uterine disorders; this technique missed 62.5% of major intrauterine disorders, and all endometrial disorders were still present in the removed uterus.

Research paper thumbnail of Endometrial damage by antiestrogens in a postmenopausal breast cancer patient

Acta Obstetricia et Gynecologica Scandinavica, 2002

Research paper thumbnail of Sonographic, hysteroscopic, and histologic evaluation of the endometrium in postmenopausal women with breast cancer receiving tamoxifen

The Journal of the American Association of Gynecologic Laparoscopists, 2000

To evaluate the estrogenic effects of tamoxifen on the endometrium in postmenopausal women with b... more To evaluate the estrogenic effects of tamoxifen on the endometrium in postmenopausal women with breast cancer. Consecutive study (Canadian Task Force classification II-2). University-affiliated hospital. Thirty-three women. Interventions. All patients underwent transvaginal sonography (TVS) and color flow Doppler of endometrial vessels, hysteroscopy, and, if necessary, endometrial biopsy or other operative hysteroscopic procedures. In four women the endometrium was thin on TVS and atrophic at hysteroscopic assessment. In 29 women with thick endometrium on TVS, hysteroscopy and endometrial biopsy showed atrophy (11 patients), hyperplasia (5), polyps (11), and well-differentiated adenocarcinoma (2). The two endometrial cancers were present in women with uterine bleeding. In women with positive histologic findings, the endometrium was significantly thicker (p = 0.04) and duration of tamoxifen therapy longer than in those with negative findings, although this was not statistically significant (p = 0.067). We believe regular assessment of the endometrium by TVS should be performed in postmenopausal patients at the start of the tamoxifen therapy, and hysteroscopy in women with a thick endometrium or postmenopausal bleeding. We believe that patients with thin endometrium on TVS at the beginning of tamoxifen therapy, who have no abnormal uterine bleeding should be screened with these examinations for 2 years.