ULTRASONOGRAPHIC EVALUATION OF THE ENDOMETRIUM AND CORRELATION WITH ENDOMETRIAL SAMPLING IN POSTMENOPAUSAL PATIENTS TREATED WITH TAMOXIFEN

Seventy-two asymptomatic, postmenopausal women treated with tamoxifen for breast cancer were studied prospectively with vaginal ultrasonogra phy, followed by endometrial sampling. Seventy-one patients demonstrat ed an endometrial echo of more than 5 mm, and one displayed an endomet rial echo of less than 5 mm. No patient with an endometrial echo of le ss than 5 mm displayed any endometrial pathology. Different endometria l pathologic conditions were found when the endometrial echo was over 5 mm. When classifying those patients whose ultrasonic endometrial wid ths were wider than 5 mm, on the basis of different endometrial histol ogic findings, no obvious correlation was found between the various pa thologic endometrial findings and endometrial thickness. Thus, a ''thi cker'' endometrial sonographic image did not necessarily correlate wit h pathologic endometrial findings. When ultrasonic endometrial thickne ss of 5 mm was considered the upper limit of normal, the sensitivity o f ultrasonography in correlating to positive histologic findings was 9 1% and the specificity was 96%. These findings suggest that there is g ood correlation between endometrial width measured by ultrasonographic assessment and histologic findings.