title: Clinical significance of inadequate endometrial biopsies prior to hysterectomy.
abstract: OBJECTIVE
  To evaluate preoperative clinical risk factors associated with significant uterine histopathologic abnormalities in final hysterectomy specimens in patients with inadequate preoperative endometrial biopsies.
  
  
  METHODS
  This is an institutional review board-approved, retrospective cohort analysis of 469 consecutive patients who underwent preoperative endometrial biopsies with subsequent hysterectomy from January 1, 2005, to December 31, 2009, at the University of Louisville Medical Center. We analyzed risk factors for inadequate biopsy and for final diagnosis of endometrial pathology (defined as endometrial hyperplasia or uterine cancer).
  
  
  RESULTS
  Of the 469 preoperative endometrial biopsies reviewed, 26.2% (123/469) were inadequate (IBx) and 73.8% (346/469) were adequate and benign. IBx on endometrial biopsies was associated with a greater risk of having significant uterine histopathologic abnormalities on final hysterectomy specimens (6.5% vs. 2.3%, RR 2.8 [95% CI 1.1-7.3], p = 0.04).
  
  
  CONCLUSIONS
  Although inadequate endometrial biopsies are a common finding, they can be associated with significant uterine histopathologic abnormalities on final hysterectomy specimens.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Women's Health, and the Department of Pathology, University of Louisville, KY 40292, USA.
authors.forename: Emily H
authors.initials: EH
authors.lastname: Turney
authors.forename: Hanan
authors.initials: H
authors.lastname: Farghaly
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Eskew
authors.forename: Lynn P
authors.initials: LP
authors.lastname: Parker
authors.forename: Michael R
authors.initials: MR
authors.lastname: Milam
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D015331:Cohort Studies; D004714:Endometrial Hyperplasia / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D017698:Postmenopause; D011300:Preoperative Care; D012189:Retrospective Studies; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D013629:Tamoxifen / Q000627:therapeutic use; D014594:Uterine Neoplasms / Q000473:pathology
chemical_list: D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen