Sonohysterography for evaluation of endometrial abnormalities associated with tamoxifen therapy for breast cancer

ObjectiveTo evaluate sonohysterography for the diagnosis of endometrial abnormalities in women treated with tamoxifen for breast cancer.Patients and methodsWe assessed 37 women treated with tamoxifen for breast cancer who underwent sonohysterography and correlative endometrial biopsy for evaluation of postmenopausal bleeding or thickened endometrium greater than 8 mm. In 14 patients, endometrial biopsy was followed by endovaginal sonography to ensure removal of endometrial pathology. Sonohysterography findings were compared with histopathology results.ResultsSonohysterography findings coincided with histopathology results in 27 of 37 cases including 19 of 23 cases of endometrial polyps, 6 of 8 cases with thickened endometria and two cases had normal endometrium. Sonohysterography findings did not coincide with histopathology in 3 of the 14 cases who underwent endovaginal sonography after endometrial biopsy compared to 7 of the 23 cases who did not undergo such examination and 4 of these missed 7 cases were for endometrial polyps.ConclusionSonohysterography is a useful procedure for the diagnosis of endometrial abnormalities in tamoxifen-treated women. Endometrial abnormalities are better diagnosed on sonohysterography than on endometrial biopsy which has the limitation of some missed endometrial polyps, a problem that may be minimized by performing endovaginal sonography after endometrial biopsy.