title: The role of transvaginal ultrasound or endometrial biopsy in the evaluation of the menopausal endometrium.
abstract: All postmenopausal women with vaginal bleeding need endometrial assessment. Disposable suction piston biopsy devices have virtually replaced dilatation and curettage despite little scientific validation. In patients with known carcinoma, false-negative rates with such devices range from 2.5-32.4%. Large prospective studies have shown that an endometrial thickness <or= 4 mm on transvaginal ultrasound in postmenopausal women with bleeding has a risk of malignancy of 1 in 917. Thus, in postmenopausal patients with bleeding, biopsy is not indicted when endometrial thickness is <or= 4 mm. The significance of a thick endometrial echo in nonbleeding postmenopausal women has not been validated and need not require automatic tissue sampling.
authors: Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA.
authors: Steven R
authors: SR
authors: Goldstein
mesh_terms: D001706:Biopsy; D003560:Cysts / Q000000981:diagnostic imaging / Q000601:surgery; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000175:diagnosis; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D015907:Hysteroscopy; D008875:Middle Aged; D017698:Postmenopause; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014591:Uterine Diseases / Q000175:diagnosis / Q000601:surgery; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging; D014621:Vagina / Q000000981:diagnostic imaging