title: Significance of abnormal sonographic findings in postmenopausal women with and without bleeding.
abstract: OBJECTIVE
  We sought to determine the incidence of cancer and to compare pathologic outcomes in bleeding and non-bleeding postmenopausal patients who underwent hysteroscopy.
  
  
  METHODS
  We conducted a retrospective chart review of 294 postmenopausal women with abnormal uterine bleeding and 142 postmenopausal women without symptoms who underwent hysteroscopy. An 11 mm cut-off for asymptomatic women was applied to determine whether this endometrial thickness threshold would differentiate women with and without endometrial cancer in the asymptomatic group.
  
  
  RESULTS
  In symptomatic patients, 14 were found to have endometrial cancer and 10 were found to have endometrial hyperplasia. In the asymptomatic group, two women (1.4%) were found to have endometrial cancer with average thickness 17.5 mm, and one (0.71%) was found to have endometrial hyperplasia. Logistic regression models showed the risk of a bleeding patient developing endometrial cancer at an endometrial thickness of 4 mm was the same as the risk in a non-bleeding patient at a thickness of 15 mm.
  
  
  CONCLUSIONS
  Asymptomatic postmenopausal women have a low risk of having significant endometrial pathology. Cancer was approximately four times more prevalent in women with bleeding than in women with no bleeding.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Menzies
authors.forename: Sarah
authors.initials: S
authors.lastname: Wallace
authors.forename: Marguerite
authors.initials: M
authors.lastname: Ennis
authors.forename: Alison
authors.initials: A
authors.lastname: Bennett
authors.forename: Michelle
authors.initials: M
authors.lastname: Jacobson
authors.forename: Gina
authors.initials: G
authors.lastname: Yip
authors.forename: Wendy
authors.initials: W
authors.lastname: Wolfman
mesh_terms: D000368:Aged; D004714:Endometrial Hyperplasia / Q000175:diagnosis; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D016015:Logistic Models; D008875:Middle Aged; D017698:Postmenopause; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D014592:Uterine Hemorrhage