Evaluation of Saline Sonohysterography Findings in Patients with Breast Cancer Receiving Tamoxifen Adjuvant Therapy

Background: Transvaginal ultrasound is one of the most common means toexamine endometrial cavity lesions although its negative results are morevaluable. Saline sonohysterography can reduce the number of false negative ratesof endometrial lesions diagnoses in Tamoxifen consumers. The Objective of thisstudy was to determine the diagnostic values of saline infusion sonohysterography(SIS) and hysteroscopy as gold standard in diagnosis of endometrial pathologies inpatients with breast cancer receiving adjuvant therapy withTamoxifen for at least ۶months.Methods: This cross-sectional study was conducted on ۴۰ patients with breastcancer who were treated with for at least ۶ months and referred by the gynecologistfor evaluation. Age, duration of Tamoxifen use and symptoms were recorded.Patients were examined by saline sonohysterography. Ultrasonic endometrialfindings were recorded. Patients with positive findings were referred forhysteroscopy and biopsy was taken for pathologic examination. Then wecompared the results.Results: In total, ۴۰ patients with a mean age of ۴۶.۵±۷.۸۱ years and meanduration of Tamoxifen treatment ۱۸.۴ ±۱۳.۹۸ months were included. There wereintrauterine lesions in ۲۲ patients and they did not undergo hysteroscopy. Forothers, ۹ patients with endometrial polyp (۲۱.۴۱%), ۳ patients with endometrialhyperplasia (۷.۱۴%) were found. The accuracy of SSH in diagnosing endometrialpolyp, endometrial hyperplasia and submucosal fibroma were ۸۷.۵%, ۹۲.۵%,۹۷.۵%, respectively.Conclusions: Saline sonohysterography is a viable option for screening of thepatients instead of endometrial biopsy as it has great negative predictive value.Sonohysterography is easy, non-invasive, inexpensive and has great accuracy.