Objective: To evaluate sonohysterography for the diagnosis of endometrial abnormalities
in women treated with tamoxifen for breast cancer.
Patients and methods: We assessed 37 women treated with tamoxifen for breast cancer who underwent
sonohysterography and correlative endometrial biopsy for evaluation of postmenopausal
bleeding or thickened endometrium greater than 8 mm. In 14 patients, endometrial biopsy was followed
by endovaginal sonography to ensure removal of endometrial pathology. Sonohysterography
findings were compared with histopathology results.
Results: Sonohysterography findings coincided with histopathology results in 27 of 37 cases including
19 of 23 cases of endometrial polyps, 6 of 8 cases with thickened endometria and two cases had
normal endometrium. Sonohysterography findings did not coincide with histopathology in 3 of the 14
cases who underwent endovaginal sonography after endometrial biopsy compared to 7 of the 23 cases
who did not undergo such examination and 4 of these missed 7 cases were for endometrial polyps.
Conclusion: Sonohysterography is a useful procedure for the diagnosis of endometrial abnormalities
in tamoxifen-treated women. Endometrial abnormalities are better diagnosed on sonohysterography
than on endometrial biopsy which has the limitation of some missed endometrial polyps, a problem
that may be minimized by performing endovaginal sonography after endometrial biopsy.
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