Risk of discovering endometrial carcinoma or atypical hyperplasia during hysteroscopic surgery in postmenopausal women. |
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| Authors: | A Agostini L Cravello F Bretelle A S Demaisonneuve V Roger B Blanc |
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| Institution: | 1. CICS, UBI - Health Sciences Research Center, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal;2. Labfit, HPRD - Health Products Research and Development, Lda, Edifício UBIMEDICAL, Estrada Municipal 506, 6200-284 Covilhã, Portugal;3. Pharmacy Department, Centro Hospitalar Cova da Beira EPE, Quinta do Alvito, 6200-251 Covilhã, Portugal;4. Child and Woman''s Health Department, Centro Hospitalar Cova da Beira EPE, Quinta do Alvito, 6200-251 Covilhã, Portugal;1. Mount Sinai Fertility, 250 Dundas St. W, Suite 700, Dept of Obstetrics and Gynecology, Mount Sinai Hospital, 600 University Ave., University of Toronto, Toronto ON, M5T 2Z5, Canada;2. Trio Fertility, 655 Bay St., Suite 1101, Toronto ON, M5G 2K4, Canada;3. True North Imaging, 7330 Yonge St., Suite 120, Thornhill ON, L4J 7Y7, Canada;1. Institute of Additive Manufacturing, Jiangxi University of Science and Technology, Nanchang 330013, China;2. College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China;3. Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China;4. Ganjiang Innovation Academy, Chinese Academy of Sciences, Ganzhou 341119, China;1. Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China;2. Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China;3. Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China;4. Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China |
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| Abstract: | STUDY OBJECTIVE: To assess the risk of diagnosing endometrial carcinoma or atypical hyperplasia in tissue resected during hysteroscopy performed for intrauterine pathology presumed benign in postmenopausal women. DESIGN: A single-center prospective study (Canadian Task Force classification II-2). SETTING: Department of Gynecology, La Conception Hospital, Marseille, France. PATIENTS: Three hundred twenty-five women with intrauterine pathology, presumed benign, causing postmenopausal bleeding or bleeding related to hormone replacement therapy. INTERVENTION: All women had an endometrial biopsy after diagnostic hysteroscopy to exclude endometrial carcinoma or atypical hyperplasia. Then they underwent hysteroscopic surgical resection (203, 62.5%) or endometrial ablation (122, 37.5%). MEASUREMENTS AND MAIN RESULTS: Two cases each (0.6%) of endometrial carcinoma and endometrial atypical hyperplasia were discovered that were missed by preoperative evaluations. CONCLUSION: Outpatient hysteroscopy and endometrial biopsy do not eliminate the finding of carcinoma or endometrial atypical hyperplasia, as these disorders may be discovered during hysteroscopic surgery. |
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