Endometrial Evaluation with Transvaginal US and Hysterosonography in Asymptomatic Postmenopausal Women with Breast Cancer Receiving Tamoxifen

Abstract

In asymptomatic postmenopausal women receiving tamoxifen, 6 mm is the optimal endometrial thickness cutoff for diagnosing endometrial abnormalities with transvaginal US. Further examination with hysterosonography can improve specificity by reducing the high false-positive rate of transvaginal US.

Peri- and Postmenopausal Uterine Bleeding Transvaginal Ultrasound with Hysterosonography and Diagnostic Correlation with Hysteroscopy

“…In asymptomatic women, the upper limit for normal endometrial thickness and the usefulness of TVS screening remain controversial. Various authors [8][9][10][11] have reported transvaginal sonographic endometrial thicknesses of 5, 9, and 10 mm as abnormal cut-off values for the identification of endometrial disease in asymptomatic perimenopausal women. However, the results of these studies 9,11 are limited by verification bias and by small sample size.…”

“…Various authors [8][9][10][11] have reported transvaginal sonographic endometrial thicknesses of 5, 9, and 10 mm as abnormal cut-off values for the identification of endometrial disease in asymptomatic perimenopausal women. However, the results of these studies 9,11 are limited by verification bias and by small sample size. [9][10][11] Recent study studying women on tamoxifen suggested that the optimal endometrial thickness cut-off for identification of abnormalities (polyps and submucosal fibroids) was > 6 mm, if maximal test accuracy (sensitivity and specificity) is desired.…”

“…However, the results of these studies 9,11 are limited by verification bias and by small sample size. [9][10][11] Recent study studying women on tamoxifen suggested that the optimal endometrial thickness cut-off for identification of abnormalities (polyps and submucosal fibroids) was > 6 mm, if maximal test accuracy (sensitivity and specificity) is desired. With this cut-off value, the sensitivity was 84.1% and specificity 58.2%.…”

AIUM Practice Guideline for the Performance of Pelvic Ultrasound Examinations

“…Sonohysterography may be a useful adjunct for evaluating the patient with abnormal or dysfunctional uterine bleeding or to further clarify an abnormally thickened endometrium. 7 If the patient has an intrauterine contraceptive device, its location should be documented. (See the AIUM Practice Guideline for the Performance of Sonohysterography.…”

Algorithmic Workup of Abnormal Vaginal Bleeding with Endovaginal Sonography and Sonohysterography: Self-Assessment Module

“…Option B is not the best response. What constitutes the normal endometrial thickness for this group of patients is conSonography and Sonohysterography of Vaginal Bleeding troversial, with 5-8 mm having been proposed [5][6][7]. Option E is not the best response.…”