[ @entity440 and XXXX ].

@entity172 @entity1 @entity43 @entity3556 @entity0 @entity440 @entity242 @entity5 @entity5345 @entity189
@entity440 is a selective @entity172 receptor modulator (SERM) with pro- and anti-estrogenic properties. Currently it is the most widely used agent for first line treatment against hormone sensitive metastatic @entity0 and the only approved hormonal agent for adjuvant treatment of organ confined @entity0 . Furthermore, its uses have been extended for the treatment of @entity0 @entity1 . In such settings the most worrisome side effect of @entity440 is its ability to increase the rates of uterine @entity5 . It has been claimed that most of these @entity5 are found at an early stage because of @entity3556 . Moreover, it has been shown that for most @entity1 transvaginal ultrasound is an ineffective screening method for the early detection of uterine @entity189 . It is important, however, to notice that long term @entity440 treatment can cause metastatic @entity5 but also @entity242 (mainly malignant mixed @entity5 . It should be noted that, at least for the special population of @entity5345 mutation carriers, transvaginal ultrasound can increase our ability for the earlier @entity43 . Thus, we believe that there is still a place for the use of transvaginal ultrasound in special populations. This is specifically for long term @entity440 users (more than the usually recommended five years), @entity1 with a higher chance of having uterine @entity189 (namely very high body weight, strong family history) and @entity1 with a high index of suspicion as carriers of a @entity5345 mutation. Until new second generation SERMs and aromatase inhibitors are shown to possess better anti- @entity5 abilities than @entity440 , this drug will remain in wide use, however, we must not overlook its possible rare side effects.
