Endometrial brush cytology in the surveillance of post-menopausal patients under tamoxifen: a prospective longitudinal study

Eur J Obstet Gynecol Reprod Biol. 2007 May;132(1):126-8. doi: 10.1016/j.ejogrb.2006.04.023. Epub 2006 Jun 22.

Abstract

Objective: To evaluate cytological sampling of endometrium using Endobrush (Lab CCD, Paris, France) in the surveillance of tamoxifen-treated patients.

Study design: Between February 1995 and October 1997, 687 tamoxifen-treated patients had serial ultrasound screening for endometrial pathology. In case of endometrial double layer thickness of more than 8mm, a cytological examination of endometrium was attempted followed by hysteroscopy and curettage.

Results: One hundred and eighty-nine patients had abnormal endometrial ultrasound findings. Cytological smear was not obtained in 39 patients because of cervical stenosis or pain in 33 and 6 cases, respectively. One hundred and fifty patients had cytological endometrial sampling followed by hysteroscopy and curettage. Cytological and histological findings correlated well in 145 cases (141 benign lesions and 4 endometrial cancers). There were five false positive (four atypia and one cancer). All patients remained free of endometrial cancer at 5 years follow-up.

Conclusion: In tamoxifen-treated patients, endometrial cytology was reliable for detection of endometrial pathology, and was well accepted by the patients.

Publication types

  • Evaluation Study

MeSH terms

  • Antineoplastic Agents, Hormonal / pharmacology*
  • Biopsy / instrumentation
  • Biopsy / methods*
  • Cytodiagnosis / methods*
  • Cytological Techniques / instrumentation
  • Cytological Techniques / methods
  • Endometrium / cytology*
  • Endometrium / diagnostic imaging
  • Endometrium / drug effects
  • Female
  • Humans
  • Patient Satisfaction
  • Postmenopause / drug effects*
  • Prospective Studies
  • Sensitivity and Specificity
  • Specimen Handling / instrumentation
  • Specimen Handling / methods
  • Tamoxifen / pharmacology*
  • Ultrasonography

Substances

  • Antineoplastic Agents, Hormonal
  • Tamoxifen