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- W1977730682 abstract "To the Editors: We appreciate the comments of Cohen, Tepper, and Beyth regarding our study. We disagree with the statement that transvaginal ultrasonographic exami nation is an accurate and useful diagnostic and screening method for diagnosing endometrial disease in post menopausal tamoxifen-treated patients. The literature is filled with publications that search to define the role of transvaginal ultrasonographic scanning in this patient population. Despite numerous studies, no abnormal cutoff' for endometrial thickness has been defined in postmenopausal patients treated with tamoxifen, and the role of transvaginal ultrasonography is unclear. We sug gest the reason for the confusion is that patients with endometrium, in the absence of endometrial disease to account for the thickening (ie, endometrial polyp, hyperplasia, or cancer), likely have endometrial cystic Endometrial cystic atrophy may not be di agnosed without hysterectomy. We are not suggesting that patients treated with ta moxifen undergo transvaginal ultrasonographic exami nation to screen for endometrial disease. However, if a patient is examined by a clinician after an ultrasonogra phy scan demonstrates abnormal endometrial thicken ing, it is reasonable to perform sonohysterography, fol lowed by endometrial sampling (curettage, hysteroscopy if polyp noted). If an endometrial biopsy is performed initially, patients with endometrial hyperplasia or adeno carcinoma would not need to undergo sonohysterogra phy, although admittedly each of these is a rare event compared with endometrial polyps. Finally, the authors of the letter misquoted our arti cle-we did not state that .. .if sonohysterography fails to demonstrate an endometrial polyp, the patient likely has endometrial cystic atrophy. This statement is indeed not accurate. We stated that endometrial cystic atrophy may explain thickened endometrium on transvaginal ultra sonographic examination in postmenopausal patients treated with tamoxifen who have no evidence of en dometrial polyps, hyperplasia, or cancer on surgical eval uation." @default.
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- W1977730682 date "1999-01-01" @default.
- W1977730682 modified "2023-09-25" @default.
- W1977730682 title "Ultrasonographic evaluation of endometrial disease in postmenopausal patients with breast cancer and tamoxifen treatment" @default.
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- W1977730682 doi "https://doi.org/10.1016/s0002-9378(11)70007-2" @default.
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