The significance of a thickened endometrial echo in asymptomatic postmenopausal patients

Worley, Michael J.; Dean, Kathleen L.; Lin, Stephanie N.; Caputo, Thomas A.; Post, Robert C.

doi:10.1016/j.maturitas.2010.10.007

Cited by 17 publications

(8 citation statements)

References 10 publications

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“…Risks of malignancies or EIN were minimal among asymptomatic postmenopausal women in previous reports [6,15–17] and in our study. It is questioned whether endometrial thickness was a sole indication of surgical intervention in asymptomatic postmenopausal women.…”

Section: Discussionsupporting

confidence: 64%

“…[5] Among asymptomatic postmenopausal women with a thickened endometrium (traditionally defined as ≥5 mm), studies stated a malignancy rate 0% to 3%. [6,7] For the reasonable cut-off value of endometrial thickness, scholars once recommended various criterion based on their experiences rather than evidences. [8] Primary aim of this study is to explore the risk of endometrial malignancies and related factors among asymptomatic postmenopausal women with endometrial thickness ≥5 mm.…”

Section: Introductionmentioning

confidence: 99%

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Risk of malignancies among asymptomatic postmenopausal women with thickened endometrium

2019

Medicine

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The risk of malignancies and related factors among asymptomatic postmenopausal women with thickened endometrium in transvaginal sonography (TVS) are unclear. In this longitudinal study at a tertiary teaching hospital, all medical records of hysteroscopy were searched and retrospectively reviewed according to age, TVS results and diseases coded as International Classification of Diseases version 10. Asymptomatic postmenopausal women with endometrial thickness ≥5 mm from January 2006 to January 2016 were included. A follow-up was provided up to January 2017. Four hundred eighty-eight patients were included with a median endometrial thickness of 8 mm (range 5–30) in TVS. The most common pathologic findings were polyps (51.0%) and normal endometrium (34.2%). Fifteen (3.1%) and 10 cases (2.0%) had endometrial intraepithelial neoplasia (EIN) and carcinoma. Patients with carcinoma had significantly more abnormal serum CA125, thicker endometrium, and more lesions with positive Doppler flow signals. In receiver operating characteristic curve analysis, endometrial thickness of 12 mm had the best predictive ability for malignancies. In multivariate analysis, endometrial lesion with positive Doppler flow signals in TVS was the only independent factor for EIN/carcinoma (odds ratio [OR] 8.0, 95% confidence interval [CI] 1.4–45.1) and for carcinoma (OR 16.0, 95% CI 1.3–192.8). After a median follow-up of 45 months, carcinoma occurred in 1 of 35 (2.8%) women with repeated thickened endometrium. Among asymptomatic postmenopausal women with thickened endometrium, the risk of EIN and malignancy was minimal but worth of long-term follow-up. Endometrial lesions with positive Doppler flow signals in TVS suggested a high risk of malignancy.

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Risk of malignancies among asymptomatic postmenopausal women with thickened endometrium

2019

Medicine

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“…In the asymptomatic patients, several studies indicate that a transvaginal ultrasound is not a good screening method [ 13 – 15 ]. A good cut-off point to conduct further studies in postmenopausal patients would be 10 mm based on our results and as compared with those reported by other authors [ 16 ].…”

Section: Discussionsupporting

confidence: 59%

Endometrial study in patients with postmenopausal metrorrhagia

Torrijos

Merlo

Mirasol

et al. 2016

aoms

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IntroductionThe aim of the study was to devise a strategy to diagnose malign endometrial pathologies (adenocarcinoma or atypical hyperplasia) that minimizes the number of invasive tests done (hysteroscopy, aspiration biopsy or curettage) with no loss of its detection efficiency.Material and methodsWe retrospectively studied the clinical histories of 779 postmenopausal women at the University Hospital Complex of Albacete, for whom an endometrial study had been done (hysteroscopy, aspiration biopsy or curettage) with a 1-year follow-up between 1 March 2006 and 31 March 2008.ResultsThere were 77 cases of a malignant pathology (66 adenocarcinomas and 11 hyperplasias with atypia); 96.1% had metrorrhagia, and there were only 3 cases of asymptomatic patients (all 3 presented endometrial thickness of > 5 mm: 10, 12 and 15 mm). The sensitivity and specificity of the transvaginal ultrasound, with a 5 mm cut-off point to diagnose a malignant pathology, were 98.4% and 30.1%, respectively; 89.1% and 99.6%, respectively, for aspiration biopsy; 83.9% and 99.1%, respectively, for hysteroscopy without biopsy; and both were 100% for biopsy. Statistical significance was considered at p < 0.05 and confidence intervals were calculated at 95%.ConclusionsIn postmenopausal women with metrorrhagia, the first action to take is to do a transvaginal ultrasound, followed by en endometrial study, but only if the endometrium is irregular or endometrial thickness is ≥ 5 mm; in asymptomatic women, the cut-off point should be set at 10 mm. The immediate method of choice is an ambulatory biopsy.

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“…The reported cancer percentages of the postmenopausal asymptomatic polyp cases were between 0% and 4,9% (Table 1). [4][5][6][7][8][9][10] Schmidt et al, reported the highest cancer percentage at the asymptomatic cases. In their survey, hysteroscopy differentiate all of the cancer cases from the benign cases at patients double endometrial layer lining greater than 6mm, but insufficient to differentiate hyperplasia cases.…”

Section: Discussionmentioning

confidence: 98%