Should ultrasound assessment of the endometrium be necessary in patients treated with Tamoxifen?

This editorial reviews evidence on whether routine ultrasonographic assessment of endometrial thickness is necessary in women treated with tamoxifen, highlighting differences between premenopausal and postmenopausal users and summarizing known risks of uterine effects. It notes that tamoxifen can increase endometrial thickness and cause benign ultrasonographic findings such as sub-endometrial cysts and polyps, while the absolute risk of extra endometrial cancer is described as about 1 per 1000 women per year and endometrial cancer is extremely rare in asymptomatic premenopausal patients; a major limitation is that the paper is largely narrative and cites guideline positions without presenting new original data. The editorial emphasizes that routine screening of asymptomatic patients could lead to excessive interventions, stress, and potentially reduced adherence, while unusual bleeding warrants endometrial evaluation. Relevance to endometriosis: the paper discusses tamoxifen-associated uterine pathology and abnormal uterine bleeding but does not specifically address endometriosis or adenomyosis.

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