Sonohysterography compared with endometrial biopsy for evaluation of the endometrium in tamoxifen-treated women.
OBJECTIVE
This study was performed to compare endometrial biopsy and sonohysterography for evaluation of the endometrium in tamoxifen-treated women.


METHODS
Medical records were retrospectively reviewed to identify 51 consecutive tamoxifen-treated women who had sonohysterography and correlative endometrial biopsy for evaluation of postmenopausal bleeding or thickened endometrium of greater than 8 mm. Endometrial biopsy and sonohysterographic results were compared in all women, and for 27 (53%) women who had hysteroscopy with dilation and curettage, endometrial biopsy and sonohysterographic findings also were compared with surgical pathologic findings.


RESULTS
Thirty-two (63%) of 51 sonohysterograms revealed endometrial polyps; 4 (8%) showed endometrium of greater than 5 mm; 14 (27%) showed endometrium of less than 5 mm; and 1 (2%) was inadequate. Endometrial biopsy findings were benign endometrium in 42 (82%), polyps in 4 (8%), and insufficient samples in 5 (10%). Among the adequate sonohysterograms, 64% (32 of 50) resulted in a diagnosis of polyps (95% confidence interval, 49%-77%) whereas the corresponding proportion for endometrial biopsy was 9% (4 of 46; 95% confidence interval, 2%-21%). For the group with hysteroscopy, 24 (92%) of 26 polyps were confirmed histopathologically; 1 polyp had complex hyperplasia. Polyps were present in 23 (89%) of 26 women with benign endometrium or insufficient samples by endometrial biopsy, and only 1 confirmed polyp was identified by endometrial biopsy. The sensitivity of sonohysterography for diagnosis of endometrial polyps (100%) was significantly higher than for endometrial biopsy (4%; P < .01).


CONCLUSIONS
In tamoxifen-treated women, sonohysterography provides a significant improvement in sensitivity for diagnosis of endometrial polyps compared with endometrial biopsy.
Hann
Lucy E
LE
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. hannl@mskcc.org
Kim
Cathleen M
CM
Gonen
Mithat
M
Barakat
Richard
R
Choi
Patricia H
PH
Bach
Ariadne M
AM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy; D004714:Endometrial Hyperplasia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D016889:Endometrial Neoplasms / Q000139:chemically induced* / Q000000981:diagnostic imaging; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000187:drug effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D011127:Polyps / Q000139:chemically induced* / Q000000981:diagnostic imaging; D017698:Postmenopause; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014463:Ultrasonography
D013629:Tamoxifen