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

Objective: To evaluate cytological sampling of endometrium using Endobrush (R) (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 8 mm, 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. (c) 2006 Elsevier Ireland Ltd. All rights reserved.