IMR Press / EJGO / Volume 43 / Issue 1 / DOI: 10.31083/j.ejgo4301003
Open Access Review
Efficacy of sonohysterography and hysteroscopy for evaluation of endometrial lesions in tamoxifen treated patients: a systematic review
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1 Department of General Surgery and Medical Surgical Specialties, University of Catania, 95125 Catania, Italy
2 Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy

Academic Editor: Enrique Hernandez

Eur. J. Gynaecol. Oncol. 2022 , 43(1), 3;
Submitted: 20 October 2021 | Revised: 2 January 2022 | Accepted: 5 January 2022 | Published: 12 January 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Objective: This review aims to evaluate the incidence of endometrial lesions in tamoxifen-treated breast cancer patients identified by hysteroscopy (HS) and sonohysterography (SIS) and the diagnostic accuracy of the two methods to detect them. Methods: A systematic review of the literature concerning the role of HS and SIS for evaluation of the endometrium in tamoxifen-treated breast cancer patients was performed. We searched MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, congress abstracts, and Grey literature (Google Scholar; British Library). The search terms used were “hysteroscopy”, “hysterosonography”, “sonohysterography” combined with “tamoxifen”; 89 citations were identified and selected in the initial screening. Results: 28 studies were included in the systematic review. There were 61 citations excluded because they were review articles (n = 9) or case report (n = 5) and non-English articles (n = 8), and had too little information in the full text (n = 39). Similar accuracy between SIS and HS in detection of endometrial tamoxifen-related lesions was found. Conclusions: SIS may represent a minimally invasive, simple, safe, well-tolerated and cost-effective alternative to HS, associated with few contraindications and no potential complications.

Breast cancer
Fig. 1.
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