Two-year follow-up of 263 patients with post/perimenopausal vaginal bleeding and negative initial biopsy.
Patients with post- or perimenopausal bleeding (PMB) whose initial endometrial biopsy or dilation and curettage (D&C) reveals benign or insufficient tissue may eventually be diagnosed with endometrial cancer or complex endometrial hyperplasia. We studied 286 consecutive patients with PMB who had either an endometrial biopsy or D&C at Brigham and Women's Hospital during November 1990 to April 1991 and reviewed their subsequent specimens after a minimum of 23 months of follow-up. Of the initial 286 patients with PMB, 6 (2%) had endometrial cancer on their index biopsy, 17 (6%) had complex hyperplasia, and 201 (70%) had other benign findings. Sixty-two (22%) had "tissue insufficient for diagnosis." Excluding the 23 with cancer/complex hyperplasia, there were 263 patients in the cohort, 86 of whom (33%) had further endometrial sampling during the follow-up period. Of these, four (2%) were subsequently found to have a uterine malignancy (2 of the benigns, 2 of the insufficients) and five (2%) were subsequently found to have complex hyperplasia. Of the four patients subsequently found to have cancer, two had stage I adenocarcinoma, one had stage IV adenocarcinoma, and one had stage I high-grade stromal sarcoma.
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts.
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S
Feldman
A
A
Shapter
W R
WR
Welch
R S
RS
Berkowitz
D000368:Aged; D001706:Biopsy / Q000145:classification; D015331:Cohort Studies; D004107:Dilatation and Curettage; D004714:Endometrial Hyperplasia / Q000473:pathology; D016889:Endometrial Neoplasms / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009819:Office Visits; D017698:Postmenopause; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000473:pathology* / Q000601:surgery