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Transvaginal Endometrial Sonography in Postmenopausal Women Taking Tamoxifen

From the Division of Gynecologic Ultrasound, Department of Obstetrics and Gynecology, and the Department of Pathology, Saint Francis Hospital and Medical Center, Hartford, Connecticut.

Address reprint requests to: Michael R. Tesoro, MD, Department of Obstetrics and Gynecology, Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT 06105, E-mail: mtesoro{at}stfranciscare.org

Objective: To evaluate sonographic measurements of endometrial thickness in postmenopausal women taking adjuvant tamoxifen therapy for breast cancer, and to correlate sonographic and pathologic findings to symptoms and duration of tamoxifen therapy.

Methods: Medical records and sonograms of 80 postmeno-pausal women treated for breast cancer with adjuvant tamoxifen therapy were reviewed retrospectively. Endometrial thickness was recorded as a single-layer thickness and considered abnormal when greater than 2.5 mm for post-menopausal women. Sonographic endometrial thickness was correlated to histologic findings, symptoms, and duration of tamoxifen therapy.

Results: Fifty-seven of 80 postmenopausal women (69%) had single-layer endometrial thicknesses of 2.5 mm or greater, measured by transvaginal sonography, and 55 of 57 had endometrial biopsies or dilatations and curettage. Biopsies detected 24 cases of abnormal endometria, including endometrial carcinoma (two), breast carcinoma metastatic to the endometrium (one), endometrial polyps (13), tubal metaplasia (three), and benign endometrial hyperplasia (five). Using a single-layer endometrial thickness greater than 2.5 mm by transvaginal ultrasound, 21 of 24 (87.5%) women with abnormal endometria were detected. Women with abnormal pathologic findings had a significantly thicker mean single-layer endometrial thickness than those with normal findings, 7 mm versus 4 mm (P < .01). Twelve women had postmenopausal bleeding, all of whom had a single-layer endometrial thickness greater than 2.5 mm on transvaginal sonography.

Conclusion: With a sensitivity of detecting endometrial abnormalities of 84%, transvaginal sonography was useful for studying postmenopausal tamoxifen-treated women.

This article has been cited by other articles:

				B. Gerber, A. Krause, H. Muller, T. Reimer, T. Kulz, J. Makovitzky, G. Kundt, and K. Friese Effects of Adjuvant Tamoxifen on the Endometrium in Postmenopausal Women With Breast Cancer: A Prospective Long-Term Study Using Transvaginal Ultrasound J. Clin. Oncol., October 20, 2000; 18(20): 3464 - 3470. [Abstract] [Full Text] [PDF]

				A. Steiner and M. R. Tesoro TRANSVAGINAL ENDOMETRIAL SONOGRAPHY IN POSTMENOPAUSAL WOMEN TAKING TAMOXIFEN Obstet. Gynecol., August 1, 1999; 94(2): 321 - 322. [Full Text] [PDF]