Please use this identifier to cite or link to this item: http://hdl.handle.net/11452/25937
Title: The endometrium in asymptomatic breast cancer patients on tamoxifen: Value of transvaginal ultrasonography with saline infusion and Doppler flow
Authors: Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.
Develioğlu, Osman H.
Omak, Melike
Bilgin, Tufan
Esmer, Ahmet
Tüfekçi, Mehpare
6701315440
6507305700
7004103925
6602313069
6602656874
Keywords: Oncology
Obstetrics and gynecology
Tamoxifen
Endometrium
Ultrasonography
Saline infusion
Doppler
Patients receiving tamoxifen
Surgical adjuvant breast
Postmenopausal women
Uterine abnormalities
Hysteroscopy
Carcinoma
Therapy
Trial
Sonohysterography
Hysterosonography
Issue Date: May-2004
Publisher: Academic Press Inc Elsevier Science
Citation: Develioğlu, O. H. vd. (2004). “The endometrium in asymptomatic breast cancer patients on tamoxifen: Value of transvaginal ultrasonography with saline infusion and Doppler flow”. Gynecologic Oncology , 93(2), 328-335.
Abstract: Objective. To define by transvaginal ultrasonography an optimal cutoff for endometrial thickness measurements to be used in screening for endometrial pathologies in asymptomatic breast cancer patients on tamoxifen, and to evaluate the incorporation of saline infusion sonohysterography and Doppler studies into the diagnostic scheme. Methods. Sixty tamoxifen-treated women examined by transvaginal ultrasonography with saline infusion were included in this retrospective study. Variables of interest were endometrial thickness and texture, and the presence of intracavitary fluid at ultrasonography, total endometrial thickness, defined as the sum of the two endometrial layers and the presence of polypoid masses at sonohysterography, and uterine artery flow indices at Doppler ultrasonography. The dilatation and curettage performed after the sonographic scan detected pathological endometrial changes in nine cases, including six endometrial polyps, two endometrial hyperplasias, and one endometrial cancer. All parameters evaluated were compared between patients with benign and pathological endometria. Continuous variables that differed significantly between the groups were investigated further by receiver operating characteristics curve analyses and the diagnostic value of combinations of various parameters by binary logistic regression. Results. The endometrial thickness in patients with proven endometrial pathologies was significantly greater compared with women with benign endometria, both by transvaginal ultrasonography (12.7 +/- 5.5 vs. 7.0 +/- 4.5 mm; P = 0.003) and by sonohysterography (6.3 +/- 2.8 vs. 4.1 +/- 1.7 mm; P = 0.036). While saline infusion sonohysterography also revealed a significantly higher frequency of polypoid masses in the former group (67% vs. 2%; P < 0.001), no other significant differences were defined between the groups in regard to any other sonographic or Doppler parameter evaluated. For the diagnosis of any endometrial pathology, the optimal cutoffs of endometrial thickness at ultrasonography and total endometrial thickness at sonohysterography were 9.5 and 5.5 mm, with sensitivities of 89% and 78% and specificities of 78% and 84%, respectively. A logistic regression model including polypoid lesions (B = -4.935; P < 0.001) and total endometrial thickness at sonohysterography (B = 0.432; P = 0.027) as the only two independent variables had a sensitivity of 100% and specificity of 84%. Conclusion. Saline infusion sonohysterography does, yet Doppler ultrasonography does not, add to the value of endometrial thickness measurements by transvaginal ultrasonography in the screen for endometrial pathologies in asymptomatic breast cancer patients on tamoxifen.
URI: https://doi.org/10.1016/j.ygyno.2004.01.032
https://www.sciencedirect.com/science/article/pii/S0090825804000770
http://hdl.handle.net/11452/25937
ISSN: 0090-8258
Appears in Collections:Scopus
Web of Science

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