Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Comparing endometrial biopsy results with hysteroscopic pathology in women presenting with abnormal and postmenopausal uterine bleedings,” published in the December 2023  issue of Obstetrics and Gynecology by Ferrando, et al.

For a study, researchers sought to find out what the pathology results were after a blind endometrial biopsy in the office and what the pathology results were after a hysteroscopy in women who had abnormal uterine bleeding (AUB). A group study looked at all the biological women who went to a tertiary care referral center with AUB. Patients were included if they had a hysteroscopy and a blind endometrial biopsy in the same office within a year of the first one. The results of the hysteroscopy and the histology were linked to the results of the initial uterine sample.

About 689 people met the requirements to be included. The average age was 49, and the average body mass index (BMI) was 31 kg/m ². The average length of bleeding before appearance was 3.5 months, ranging from 1.5 to 9 months. An office endometrial biopsy found an endometrial polyp in 30.6% of the patients who had surgical hysteroscopic pathology showing an endometrial polyp. The endometrial biopsy did not show any intracavitary fibroids in any of the patients whose hysteroscopic pathology showed them. On hysteroscopy, 28.6% of the women who had hyperplasia without atypia were found or thought to have it on endometrial tissue. 5.9% of the women who had hyperplasia with atypia found by hysteroscopy also had this found or thought to have it on endometrial biopsy. Out of the 12 cases where cancer was proven or thought to be present on hysteroscopy, 8.3% were found on endometrial biopsy.

Focused results on office hysteroscopy and endometrial tissue don’t always match up. When cancer is suspected, an endometrial biopsy has been shown to be helpful. However, if benign local disease is expected, the endometrial cavity should not be blindly examined to make a final diagnosis. When women have vaginal bleeding that causes them to have symptoms, hysteroscopic viewing makes it easier to find problems inside the uterus.

Source: sciencedirect.com/science/article/abs/pii/S2468784723001526