Aleksandra Zielińska

Analysis of histopathological results of the endometrium in breast cancer patients treated with tamoxifen. Preliminary report.

Aim The study aimed to compare histopathological outcomes of the endometrium in breast cancer patients treated with tamoxifen. The analysis included asymptomatic women referred for abnormal ultrasound findings and symptomatic women with abnormal uterine bleeding. Material and methods The study included 86 patients hospitalized between 2013 and 2024 at the Medical University of Warsaw. Group I (n=42) comprised patients with abnormal ultrasonographic findings, while Group II (n=44) included women with abnormal uterine bleeding. All patients underwent hysteroscopy with subsequent histopathological tissue analysis. Results The most frequent histopathological diagnosis in both groups was the presence of endometrial polyps (Group I: 50.0%; Group II: 36.36%). Endometrial cancer was diagnosed in 7.14% of Group I and 9.09% of Group II patients, indicating a comparable prevalence of serious pathology. Statistically significant differences (p < 0.05) were noted between the groups only for non-atypical hyperplasia and proliferative endometrium. Conclusions The findings confirm that endometrial polyps are the most frequent pathology associated with tamoxifen use in this cohort. This preliminary report underscores the critical need for further targeted research focusing on population-specific factors and menopausal status to develop clear, personalized clinical guidelines for screening and surveillance, particularly for premenopausal women, independent of symptomatic presentation.

Updated Guidelines for the Diagnosis and Treatment of Endometrial Carcinoma: The Polish Society of Gynecological Oncology (2025v)

In 2023, the Polish Society of Gynecologic Oncology (PSGO) published clinical recommendations for the diagnosis, treatment, and care of women with endometrial cancer (EC), developed using the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. A 2025 update was initiated in response to new evidence, particularly regarding systemic therapies for metastatic, advanced, or recurrent EC, and the introduction of an updated FIGO classification. A targeted literature review identified relevant phase III clinical trials and systematic reviews, including RUBY, GY-018, AtTend, and DUO-E. These trials were critically assessed by an Expert Panel in accordance with the AGREE II methodology. Updated recommendations were formulated based on this evidence, with a comparative analysis of the old and new FIGO staging systems and visual updates to treatment pathways. Key changes include the addition of immunotherapy (I/O) plus chemotherapy (CHTH) as first-line treatment for all molecular subtypes of high-grade endometrioid and non-endometrioid carcinomas, replacing chemotherapy alone. For MMRp-positive cases, the 2025 version introduces the use of Olaparib alongside Durvalumab and CHTH. HER2-positive MMRp serous carcinoma remains eligible for trastuzumab in combination with CHTH. Second-line treatment guidance remains unchanged for patients who did not receive I/O plus CHTH initially. However, options for those previously treated with this combination are still under evaluation. This update ensures alignment with the latest international standards and reinforces evidence-based, personalized care for EC patients.