Transvaginal ultrasonography and hysterosonography to monitor endometrial effects in tamoxifen-treated patients

Purpose of investigation: Our purpose was to evaluate if, during tamoxifen treatment, hysterosonography may increase diagnostic accuracy when compared with transvaginal ultrasonography and to identify, when and in how many cases, further biopsies may be avoided.

Methods: We performed transvaginal utrasound in 310 asymptomatic women under tamoxifen treatment, using 8 mm endometrial thickness as the cut-off. One hundred and seven patients with an endometrium thicker than 8 mm were enrolled for hysterosonography. Parameters to be evaluated by transvaginal ultrasound and hysterosonography were thickness and structural features of the endometrium. It was possible to compare ultrasound examinations with histopathological findings obtained by biopsy in 83 patients.

Results: Globally only ten patients from the study cohort had true endometrial pathology. Based on structural features of the endometrium, we found a global accuracy of 95.6%, with 2.8% false negatives and 4.1% false positives.

Conclusion: Hysterosonography can increase diagnostic accuracy during tamoxifen treatment and may allow further invasive investigations to be avoided in patients with suggestive hysterosonographic features.

Tamoxifen; Endometrium; Transvaginal ultrasound; Hysterosonography

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