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Pauline, Doctor (MD)
Category: Health
Satisfied Customers: 8631
Experience:  Medical Doctor & Registered Pharmacist. Worked as Community pharmacist for 17 years.
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carcinoma..lumpectomy, 23 lymph nodes removed, chemo and radiation

Resolved Question:

I was diagnosed w/metactic invasive ductal carcinoma 1/2007. Had a lumpectomy, 23 lymph nodes removed, chemo and radiation. I take tamoxifen since 2007. My last period was 7/7/07. I have vaginal bleeding for the past 21 days, sometimes very heavy. I have had a pelvic exam and an ultrasound. The technician stated that my uterine walls have doubled in size since my 2007 ultrasound. My doctor says there has been no change. I have questioned him on this and still have no response or a plan for my health care. I am extreamly concerned. Please Help
Submitted: 8 years ago.
Category: Health
Expert:  Pauline replied 8 years ago.

The tamoxifen is having an impact on endometrial thickness. This is a common side effect however we would suggest that an endometrial biopsy is done as a routine precaution. It can be done in clinic without anesthetic so is very straightforward and I would suggest that you see a gynecologist for that procedure.


In terms of ongoing management, that would depend on your age and other health. For example hysterectomy would obviously stop the bleeding but is a serious operation when you have other health problems.

Customer: replied 8 years ago.
Did you view the notes on what I have already tried. What current utrasound shows?
Expert:  Pauline replied 8 years ago.

Thank you for posting that information. I have not seen it earlier. The report is reassuring in that the texture is uniform and there are no worrying features.


From your research, I am sure that you will read that tamoxifen does have the side effect of unwanted vaginal bleeding. If the norithisterone is not having any impact then I think it is worth discussing a hysterectomy with your doctor. You will be on Tamoxifen for at least another 3 years so heavy bleeding is both an inconvenience and can cause anemia. As well as the increased risk of endometrial cancer with time. In a person who is not on Tamoxifen then there are other options such as ablation or use of hormones long term, but this would not be suitable for you.


At age 52 you are quite young, so the operation should be straightforward and I would definitely discuss this with your doctor.


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