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Efficacy of sonohysterography and hysteroscopy for evaluation of endometrial lesions in tamoxifen treated patients: a systematic review

  • Federica Di Guardo1,*,
  • Giosuè Giordano Incognito1
  • Chiara Lello2
  • Gisella D’Urso1
  • Fortunato Genovese1
  • Marco Palumbo1

1Department of General Surgery and Medical Surgical Specialties, University of Catania, 95125 Catania, Italy

2Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy

DOI: 10.31083/j.ejgo4301003 Vol.43,Issue 1,February 2022 pp.78-86

Submitted: 20 October 2021 Accepted: 05 January 2022

Published: 15 February 2022

*Corresponding Author(s): Federica Di Guardo E-mail:


Objective: This review aims to evaluate the incidence of endometrial lesions in tamoxifen-treated breast cancer patients identified by hysteroscopy (HS) and sonohysterography (SIS) and the diagnostic accuracy of the two methods to detect them. Methods: A systematic review of the literature concerning the role of HS and SIS for evaluation of the endometrium in tamoxifen-treated breast cancer patients was performed. We searched MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, congress abstracts, and Grey literature (Google Scholar; British Library). The search terms used were “hysteroscopy”, “hysterosonography”, “sonohysterography” combined with “tamoxifen”; 89 citations were identified and selected in the initial screening. Results: 28 studies were included in the systematic review. There were 61 citations excluded because they were review articles (n = 9) or case report (n = 5) and non-English articles (n = 8), and had too little information in the full text (n = 39). Similar accuracy between SIS and HS in detection of endometrial tamoxifen-related lesions was found. Conclusions: SIS may represent a minimally invasive, simple, safe, well-tolerated and cost-effective alternative to HS, associated with few contraindications and no potential complications.


Hysteroscopy; Hysterosonography; Sonohysterography; Tamoxifen; Breast cancer

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Federica Di Guardo,Giosuè Giordano Incognito,Chiara Lello,Gisella D’Urso,Fortunato Genovese,Marco Palumbo. Efficacy of sonohysterography and hysteroscopy for evaluation of endometrial lesions in tamoxifen treated patients: a systematic review. European Journal of Gynaecological Oncology. 2022. 43(1);78-86.


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