Evaluation of the endometrium for malignant or premalignant disease
- Sarah Feldman, MD, MPH
Sarah Feldman, MD, MPH
- Associate Professor
- Harvard Medical School
- Section Editors
- Deborah Levine, MD
Deborah Levine, MD
- Section Editor — Imaging
- Professor of Radiology
- Director of Ob/Gyn Ultrasound
- Department of Radiology
- Beth Israel Deaconess Medical Center
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Department Chair, Gynecologic Oncology
- University of Washington Medical Center
Evaluation of the endometrium is the key component in the diagnostic evaluation of women suspected of endometrial cancer or a premalignant endometrial lesion. An endometrial sampling procedure is the gold standard for diagnostic evaluation of women with abnormal uterine bleeding in whom endometrial hyperplasia or carcinoma is a possibility (table 1). (See "Endometrial sampling procedures".)
Endometrial biopsy — The development of equipment and techniques for office-based endometrial biopsy has generally replaced the need for diagnostic dilation and curettage (D&C) performed in the operating room . Advantages of office biopsy include:
●Minimal to no cervical dilation is required.
●Local or no anesthesia is generally required.
●Performing the procedure in an office setting is less expensive than a procedure in the operating room.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- INVASIVE METHODS
- Endometrial biopsy
- Dilation and curettage
- NONINVASIVE METHODS
- Transvaginal ultrasound
- - Postmenopausal women
- Women with postmenopausal bleeding
- Asymptomatic women with endometrial thickening or fluid
- - Premenopausal women
- - Women on hormone therapy
- - Women on tamoxifen
- Saline infusion sonography
- Other imaging studies
- RISK OF TUMOR DISSEMINATION
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS
- Initial evaluation
- Evaluation of persistent bleeding