Question

A 42-year-old woman on tamoxifen for breast cancer prevention due to strong family history presents with heavy menstrual bleeding. An ultrasound scan shows a thickened endometrium of 12mm. What is the most appropriate next step?

Accepted Answer

Perform an endometrial biopsy

Answer

Reassure that this is a normal side effect of tamoxifen

Answer

Increase the dose of tamoxifen

Answer

Start cyclical progestogens

Answer

Offer a Mirena coil (IUS)

Practice question

A 42-year-old woman on tamoxifen for breast cancer prevention due to strong family history presents with heavy menstrual bleeding. An ultrasound scan shows a thickened endometrium of 12mm. What is the most appropriate next step?