Comparison of sonohysterography, hysteroscopy and hystopathological findings of endometrium in breast cancer patients taking tamoxifen

The aim of this study is to research the diagnostic value of sonohysterography, hysterescopy and endometrial biopsy in women with breast cancer taking tamoxifen and to examine the relationship between using time of tamoxifen and endometrial changes. A prospective clinical trial was conducted between 2009 October-2011 February at Akdeniz University Faculty of Medicine, Department of Obstetrics and Gynecology, Antalya, Turkey. A total of 30 symptomatic or asymptomatic patients who had breast cancer and taking tamoxifen at least for 6 months and who didn't take any hormone replacement therapy evaluated for this study. Physical and gynecological examination and pap-smear test were performed to all patients. Respectively sonohysterography and diagnostic hysterescopy were performed to the patients. But diagnostic hysterescopy was performed only the patients who had indication for this. To evaluate the accuracy of hysterescopic findings, endometrial biopsy was taken from all patients who had gone to diagnostic hysterescopy. The material send to the pathology laboratory. Statistical analysis was accomplished with use of SPSS (Statistical Package for Social Sciences) 11.0 programme. Primarily the descriptive data (mean, standart deviation, frequency) were calculated. Afterwards Student t test, the difference between two test, Mann-whitney U test, Wilcoxon Signed Ranks test and Kruskall Wallis test were used to determine and compare the quantitative data. Categorical data were determined with Chi-square test. There was no significant difference among the time of using tamoxifen and endometrial thickness (p:0.581). 43.3% of endometrial pathologies were determined with SIS and 81.4% of endometrial pathologies were determined with hysterescopy. There was significant difference between SIS and hysterescopy about identifying endometrial polyps (p:0.0001). The PPD of SIS for endometrial polyps was 56.3%, the PPD of hysterescopy was 81.3%. There was significant difference between hysterescopy and hystopathological diagnose about identifying endometrial polyps (p:0.001). Patients having symptoms and suspicious ultrasonography findings must be evaluated with hysteroscopy and must be taken biopsy.