Abstract
The thin red line – postmenopausal abnormal uterine bleeding with endometrial thickness less than 4 mm
- Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland
Aim of the study
To evaluate the risk of endometrial malignancy in postmenopausal women with abnormal uterine bleeding (AUB) with endometrial thickness ≤ 4 mm.
Material and methods
Histological assessment of endometrial samples obtained via hysteroscopy or curettage was performed in 57 women.
Results
Women with premalignancy or malignancy (24.6%) had higher endometrial thickness (by 9.7%, p = 0.01) compared to women with benign condition. Out of 12 women with atypical hyperplasia (21.1%), 5 women (8.8%) were diagnosed with simple and 7 women (12.3%) had complex hyperplasia, whereas 2 (3.5%) were diagnosed with malignancy.
Conclusions
Postmenopausal women with AUB and endometrial echo ≤ 4 mm are less likely to have a malignant condition. However, the role of histological evaluation cannot be undermined, especially in women at high risk of endometrial cancer, and routine endometrial biopsy should be considered. We recommend a change in the cut-off to 2 mm in routine practice.
Keywords
endometrial thickness, endometrial cancer, postmenopausal bleeding, abnormal uterine bleeding
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