SALINE INFUSION SONOGRAPHY (SIS) OR OFFICE HYSTEROSCOPY - WHICH ONE IS THE BEST - A PROSPECTIVE RANDOMIZED STUDY

A high proportion of asymptomatic tamoxifen-treated postmenopausal bre ast cancer patients have endometrial pathology (polyps, hyperplasia an d cancer). Thick endometrium, as measured with ultrasound, is associat ed with pathology. Transvaginal sonography (with saline infusion sonog raphy (SIS), if indicated) may be more effective and acceptable than o ffice hysteroscopy for detecting these endometrial abnormalities. Howe ver, the value of endometrial surveillance in asymptomatic patients ha s not been proven, because this would require a prospective randomised trial including several thousands of tamoxifen-treated breast cancer patients, using mortality from endometrial cancer as an end-point. (C) 1998 Elsevier Science Ltd. All rights reserved.