The role of ultrasound and symptom-based triage for detection of pathological endometrial changes in patients undergoing tamoxifen therapy for breast cancer

Abstract

Purpose of investigation: To estimate the value of ultrasonographic screening and symptom-based triage for the detection of endometrial pathologies in breast cancer patients using tamoxifen.

Method(s): A total of 292 breast cancer patients using tamoxifen were analyzed retrospectively. A total of 115 endometrial biopsies were performed on the basis of ultrasonographic examination and symptomatic status of both premenopausal and postmenopausal patients. Endometrial thickness and symptomatic status were then correlated with histopathologic data to figure out the clinical implications of ultrasonographic screening and symptom-based triage.

Result(s): The cut-off value of endometrial thickness was 8 mm for asymptomatic postmenopausal patients and the positive predictive value of transvaginal ultrasound for endometrial pathologies was 59%. The positive predictive values of symptom-based triage alone for premenopausal and postmenopausal patients were 37.5% and 48.2%, respectively.

Conclusion: Transvaginal ultrasound may be a useful method for the detection of pathological endometrial changes in asymptomatic postmenopausal breast cancer patients administered adjuvant tamoxifen. In premenopausal patients, symptom-based triage alone does not seem to be an effective diagnostic tool for endometrial pathologies.