Limited value of sonohysterography for endometrial screening in asymptomatic, postmenopausal patients treated with tamoxifen.
OBJECTIVE
Sonohysterography (SHG) has been proposed as a useful tool for the surveillance of the endometrium in patients receiving tamoxifen. This study aimed to assess the value of SHG in asymptomatic patients who would have been biopsy candidates because of abnormal transvaginal ultrasound (TVUS) results.


METHODS
The study population included postmenopausal breast cancer patients receiving adjuvant tamoxifen who had asymptomatic abnormalities at TVUS (endometrial thickness >/=8 mm or endometrial echo not adequately visualized). SHG was performed with an Aloka SSD 680 system using a 5-MHz vaginal probe, with sterile saline solution as contrast medium.


RESULTS
Forty-one patients entered the study. A regular endometrial echo was identified by SHG in 9 patients (21.9%). Histology was obtained in the remaining 32 patients with positive (n = 27, 65.8%) or unsuccessful (n = 5, 12.2%) SHG. Benign polyps (n = 15, 36.6%) and endometrial atrophy (n = 14, 34.1%) were the most common findings; 3 patients (7.3%) had simple hyperplasia.


CONCLUSIONS
Breast cancer patients with asymptomatic, tamoxifen-associated TVUS abnormalities have little additional benefit from SHG. More than 23 remain candidates for biopsy, which usually yields benign or insignificant findings.
Bertelli
G
G
Department of Medical Oncology, National Cancer Institute, Genoa, 16132, Italy. bertelli@hp380.ist.unige.it
Valenzano
M
M
Costantini
S
S
Rissone
R
R
Angiolini
C
C
Signorini
A
A
Gustavino
C
C
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001284:Atrophy / Q000139:chemically induced; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D008875:Middle Aged; D011127:Polyps / Q000000981:diagnostic imaging / Q000473:pathology; D017698:Postmenopause / Q000502:physiology*; D015203:Reproducibility of Results; D012307:Risk Factors; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014463:Ultrasonography
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen