Risk of discovering endometrial carcinoma or atypical hyperplasia during hysteroscopic surgery in postmenopausal women.
OBJECTIVE
To assess the risk of diagnosing endometrial carcinoma or atypical hyperplasia in tissue resected during hysteroscopy performed for intrauterine pathology presumed benign in postmenopausal women.


METHODS
A single-center prospective study (Canadian Task Force classification II-2).


METHODS
Department of Gynecology, La Conception Hospital, Marseille, France.


METHODS
Three hundred twenty-five women with intrauterine pathology, presumed benign, causing postmenopausal bleeding or bleeding related to hormone replacement therapy.


METHODS
All women had an endometrial biopsy after diagnostic hysteroscopy to exclude endometrial carcinoma or atypical hyperplasia. Then they underwent hysteroscopic surgical resection (203, 62.5%) or endometrial ablation (122, 37.5%).


RESULTS
Two cases each (0.6%) of endometrial carcinoma and endometrial atypical hyperplasia were discovered that were missed by preoperative evaluations.


CONCLUSIONS
Outpatient hysteroscopy and endometrial biopsy do not eliminate the finding of carcinoma or endometrial atypical hyperplasia, as these disorders may be discovered during hysteroscopic surgery.
Agostini
A
A
Service d'obstétrique et de gynécologie, Hôpital de la Conception,147 Boulevard Baille, 13385 Marseille Cedex 5, France.
Cravello
L
L
Bretelle
F
F
Demaisonneuve
A S
AS
Roger
V
V
Blanc
B
B
D000368:Aged; D001707:Biopsy, Needle; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D008875:Middle Aged; D017698:Postmenopause; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery