Significance of endovaginal ultrasonography in assessing tamoxifen-associated changes of the endometrium. A prospective study.
BACKGROUND
A prospective study was conducted investigating the value of endovaginal ultrasound in the assessment of tamoxifen-associated changes of the endometrium in patients with breast cancer.


METHODS
Seventy postmenopausal patients with breast cancer treated with anti-estrogens for at least 6 months were entered. Those with bleeding disorders and/or an endometrial thickness of > or =10 mm found on ultrasonography underwent hysteroscopy and dilatation and curettage (D&C) for further histological evaluation. In 22 patients, positive ultrasound findings could be compared with histopathology.


RESULTS
82% of the 22 patients with positive sonographic findings had a glandular-cystic hyperplasia or a glandular-cystic polyp. No adenomatous hyperplasia or endometrial cancer was observed in our series.


CONCLUSIONS
Vaginal ultrasound represents a useful diagnostic tool to detect tamoxifen-associated changes of the endometrium. A threshold of 10 mm endometrial thickness appears suitable to identify endometrial abnormalities while reducing the rate of false-positive findings to an acceptable level. However, the role of vaginal ultrasound in screening for endometrial cancer or premalignant lesions remains uncertain.
Strauss
H G
HG
Department of Gynecology, Martin-Luther-University Halle-Wittenberg, Germany.
Wolters
M
M
Methfessel
G
G
Buchmann
J
J
Koelbl
H
H
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging*
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen