Sonohysterography for evaluation of the endometrium in women treated with tamoxifen

OBJECTIVE, This study was performed to evaluate sonohysterography for the d iagnosis of endometrial abnormalities in women treated with tamoxifen. MATERIALS AND METHODS. Fifty sonohysterograms were obtained in 48 consecuti ve tamoxifen-treated women. All women were postmenopausal and had been unde rgoing tamoxifen therapy for a mean of 2.6 years. Forty-six sonohysterogram s (92%) were completed and four were unsuccessful. Sonohysterogram findings were correlated with prior endometrial biopsy results for 23 sonohysterogr ams (46%) that were preceded by endometrial biopsy Sonohysterogram findings were also compared with histopathology results, available for 38 sonohyste rograms (76%) that were followed by hysteroscopy with dilatation and curett age. RESULTS, Sonohysterography revealed 31 endometrial polyps (62%), six thicke ned endometria (12%), five normal endometria (10%), and four subendometrial cysts (8%). Surgery was avoided when seven sonohysterograms (14%) revealed normal endometria or subendometrial cysts, In the group with histopatholog ic correlation, 23 of 28 polyps were confirmed and two of five thickened en dometria were shown to represent endometrial hyperplasia, Twelve (63%) of 1 9 sonohysterograms with prior normal endometrial biopsy findings had abnorm alities on sonohysterography, including 10 polyps and two thickened endomet ria. CONCLUSION, Sonohysterography aids the diagnosis of endometrial abnormaliti es in tamoxifen-treated women even if prior endometrial biopsies have negat ive findings. In 14% of cases, visualization of a normal endometrium on son ohysterography obviated surgery.