The value of sonohysterography in the prediction of endometrial pathologies in asymptomatic postmenopausal breast cancer tamoxifen-treated patients.
BACKGROUND
The study evaluated the efficacy of sonohysterography in identifying endometrial pathologies in asymptomatic postmenopausal tamoxifen (TAM)-treated patients by evaluating its performance characteristics.


METHODS
Multiple assessments of sonohysterography evaluations of intrauterine mass diameter were evaluated by logistic regression analysis based on overall 85 patients (who had transvaginal ultrasonographic endometrial thickness of >/=8 mm) followed by hysteroscopy and endometrial histological findings. Performance characteristics were calculated with correlation to the endometrial histological findings.


RESULTS
The mean endometrial thickness was 14.6 +/- 6.2 mm, and the mean intrauterine mass diameter detected by SIS was 11.6 +/- 10.4 mm. There was a gradual decrease in sensitivity and gradual increase in specificity of the SIS studies with the increase in intrauterine mass diameter. False-negative and false-positive of SIS were 2.4% and 8.2%, respectively. ROC curve analysis of intrauterine mass revealed 5 mm as the best accurate cutoff value for the diagnosis of endometrial pathologies, with a sensitivity of 74.1%, specificity of 93.0%, and positive predictive value of 88.3% and negative predictive value of 84.2%. The risk of endometrial pathology was elevated by 1.37-fold, with any additional millimeter of diameter of the intrauterine mass. The mean diameter of the intrauterine mass gradually increased the greater the severity of the histological findings.


CONCLUSIONS
Sonohysterography improves the accuracy of diagnosis of intrauterine mass in asymptomatic postmenopausal tamoxifen-treated patients. The size of the intrauterine mass correlates with the severity of the endometrial pathology.
Markovitch
O
O
Department of Obstetrics and Gynecology, Sapir Medical Center, Kfar-Saba, 44281, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel.
Tepper
R
R
Aviram
R
R
Fishman
A
A
Shapira
J
J
Cohen
I
I
D000368:Aged; D001284:Atrophy / Q000139:chemically induced / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000139:chemically induced / Q000000981:diagnostic imaging; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014463:Ultrasonography
D013629:Tamoxifen