Ultrasound in screening of endometrial carcinoma in asymptomatic postmenopausal women

Abstract

Introduction The aim of this prospective study was to investigate whether there was a significant difference in ultrasound detection of pathologic states of endometrium between asymptomatic postmenopausal women and postmenopausal women with uterine bleeding in whom the thickness of endometrium was greater than 3 mm at ultrasound examination. Material and methods The study included 128 postmenopausal women with uterine bleeding and 29 asymptomatic posmenopausal women who underwent gynecological examination, transvaginal ultrasound examination, fractional explorative curettage and histopathological examination of the endometrium. Results The results showed no statistically significant difference between the examined groups of women in relation to the detection of pathologic states of the endometrium (polyps, hyperplasias and carcinomas) as well as between individual pathologic states, although the research showed that the asymptomatic women were more frequently presented with well-differentiated carcinoma versus the medium-differentiated carcinoma in the symptomatic group of women. Conclusion It can be concluded that the transvaginal ultrasound examination in postmenopausal women could be an adequate screening method for detection of endometrial carcinoma in early asymptomatic stage of the disease, whereas in the women with ultrasound finding of the thickened endometrium, the final diagnosis should be established by histopathological examination of the endometrium samples obtained by hysteroscopy, instead of previously used explorative curettage

Asymptomatic postmenopausal women with sonographically thickened endometrium. What do we do?

“…A recent systematic review and Meta analysis with 11,000 women does not justify the use of endometrial thickness as a screening test for endometrial carcinoma and a typical endometrial hyperplasia in asymptomatic postmenopausal women not using hormone replacement therapy (HRT) [2,3].…”

Efficiency of photodynamic therapy in the treatment of endometrial hyperplastic processes in older patients

“…Распространенность различных патологических процессов в эндометрии в постменопаузе является следующей: полипы эндометрия выявляются в 39,2-69,3%, атрофия эндометрия -в 16,72-47,4%, гиперплазия эндометрия без атипии -в 3,34-4,86%, гиперплазия эндометрия с атипией -в 0,54-5,2%, аденокарцинома -в 0,54-14%, субмукозная миома матки -в 3,65-8,5%, внутриматочные синехии -в 4,8-7,9%. Распространенность патологических процессов в эндометрии зависит от методики исследования, длительности постменопаузы и наличия маточного кровотечения (наиболее частого симптома в постменопаузе, заставляющего пациентку обратиться к врачу) [1,2,[9][10][11][12].…”