The thin red line - postmenopausal abnormal uterine bleeding with endometrial thickness less than 4 mm

• Published in: Contemporary oncology (Poznan, Poland) Vol. 23; no. 1; pp. 43 - 46
• Main Authors: Piróg, Magdalena, Kacalska-Janssen, Olga, Bereza, Tomasz, Jach, Robert
• Format: Journal Article
• Language: English
• Published: Poland Termedia Publishing House 01.01.2019
• Subjects: abnormal uterine bleeding; Biopsy; Diabetes; Endocrinology; Endometrial cancer; endometrial thickness; Gynecology; Hormone replacement therapy; Hyperplasia; Hypertension; Hysterectomy; Original Paper; postmenopausal bleeding; Systematic review; Ultrasonic imaging; Womens health; postmenopausal bleeding; endometrial cancer; endometrial thickness; abnormal uterine bleeding
• ISSN: 1428-2526; 1897-4309
• DOI: 10.5114/wo.2019.83816

To evaluate the risk of endometrial malignancy in postmenopausal women with abnormal uterine bleeding (AUB) with endometrial thickness ≤ 4 mm. Histological assessment of endometrial samples obtained via hysteroscopy or curettage was performed in 57 women. Women with premalignancy or malignancy (24.6%) had higher endometrial thickness (by 9.7%, = 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. 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.