title: A Structured Assessment to Decrease the Amount of Inconclusive Endometrial Biopsies in Women with Postmenopausal Bleeding.
abstract: OBJECTIVE
  To determine whether structured assessment of outpatient endometrial biopsies decreases the number of inconclusive samples.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Single hospital pathology laboratory.
  
  
  METHODS
  Endometrial biopsy samples of 66 women with postmenopausal bleeding, collected during the usual diagnostic work-up and assessed as insufficient for a reliable histological diagnosis.
  
  
  METHODS
  Endometrial biopsy samples were requested from the pathology laboratories. The retrieved samples were systematically reassessed by a single pathologist specialized in gynecology.
  
  
  METHODS
  Disagreement between initial assessment and conclusion after structured reassessment.
  
  
  RESULTS
  We retrieved 36 of 66 endometrial biopsy samples from six different pathology laboratories. Structured reassessment of the retrieved samples by a single pathologist specialized in gynecology did not change the conclusion in 35 of the 36 samples. The remaining sample contained a large amount of endometrial tissue and the diagnosis at reassessment was endometrial hyperplasia without atypia. All other samples contained insufficient material for a reliable diagnosis.
  
  
  CONCLUSIONS
  A structured reassessment of endometrial biopsies samples, which were classified as inconclusive due to insufficient material, did not change the conclusion. Although it might be helpful for pathologists to have diagnostic criteria for adequacy and/or inadequacy of an endometrial biopsy sample, the gain in efficiency is likely to be small.
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus MC Cancer Institute, Postbus 2040, 3000 CA Rotterdam, Netherlands; Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, Postbus 444, 3300 AK Dordrecht, Netherlands.
authors.forename: M C
authors.identifier: 0000-0002-5355-4141
authors.initials: MC
authors.lastname: Breijer
authors.affiliation: Department of Pathology, Radboud University Medical Center, Postbus 9101, 6500 HB Nijmegen, Netherlands.
authors.forename: N C M
authors.initials: NC
authors.lastname: Visser
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Postbus 22660, 1100 DD Amsterdam, Netherlands; Department of Obstetrics and Gynecology, Maastricht University Medical Center, Postbus 5800, 6202 AZ Maastricht, Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: van Hanegem
authors.affiliation: Department of Pathology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC Tilburg, Netherlands.
authors.forename: A A
authors.initials: AA
authors.lastname: van der Wurff
authors.affiliation: Clinical Research Unit, Academic Medical Center, Postbus 22660, 1100 DD Amsterdam, Netherlands.
authors.forename: B C
authors.initials: BC
authors.lastname: Opmeer
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus MC Cancer Institute, Postbus 2040, 3000 CA Rotterdam, Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: van Doorn
authors.affiliation: The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide and South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia.
authors.forename: B W J
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Obstetrics and Gynecology, TweeSteden Hospital, Dr. Deelenlaan 5, 5042 AD Tilburg, Netherlands.
authors.forename: J M A
authors.initials: JM
authors.lastname: Pijnenborg
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Postbus 22660, 1100 DD Amsterdam, Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Timmermans
mesh_terms: D001706:Biopsy; D015331:Cohort Studies; D004714:Endometrial Hyperplasia / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010045:Outpatients; D017698:Postmenopause; D011247:Pregnancy; D012189:Retrospective Studies; D013048:Specimen Handling; D014592:Uterine Hemorrhage / Q000473:pathology*