Premium
Sonohysterography Compared With Endometrial Biopsy for Evaluation of the Endometrium in Tamoxifen‐Treated Women
Author(s) -
Hann Lucy E.,
Kim Cathleen M.,
Gonen Mithat,
Barakat Richard,
Choi Patricia H.,
Bach Ariadne M.
Publication year - 2003
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2003.22.11.1173
Subject(s) - medicine , endometrial polyp , hysteroscopy , endometrial biopsy , endometrium , biopsy , endometrial hyperplasia , tamoxifen , gynecology , dilation and curettage , radiology , obstetrics , pregnancy , cancer , breast cancer , genetics , abortion , biology
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.