Prevalence of endometrial cancer in symptamatic women with
thickened endometrium
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Dr Maheswari SRINIVASAN MRCOG SpR, Mrs Shagaf BAKOUR FRCOG Consultant Obs & Gynae.
City Hospitals, Sandwell and West Birmingham NHS trust, Birmingham
Methods
Objectives
Back ground• Endometrial cancers are the most common gynaecologic
cancers.
Materials and Methods:• Post menopausal clinics are in operation in our trust.
• Retrospective review of the case notes of women who
attended with symptoms of post menopausal bleeding over 3
• Incidence of endometrial cancer is on the rise due to increase
in obesity in the world.
• Endometrial cancer predominantly occurs in the
perimenopusal and post menopausal women with thickened
endometrium.
• Risk factors include postmenopausal oestrogen therapy,
obesity, a high-fat diet, reproductive factors like nulliparity,
early menarche and late menopause, polycystic ovarian
syndrome, and tamoxifen use
year period from Jan 2008 until Dec 2010.
• There were 56 clinics
• 262 women attended.
• 101 women had thickened endometrium ET > 4 mm.
• Endometrial pipelle samples and further investigations
were carried out in these women.
• 262 patients were identified and analysed.
• All women with symptoms of post menopausal bleeding
• .16 patients were on Tamoxifen.
underwent transvaginal scanning.
• Women with thickened endometrium of more than 4mm
underwent endometrial pipelle biopsy.
• The number of women diagnosed with endometrial cancer
underwent surgical management in the form of total
have endometrial carcinoma.
• The main objective of the diagnostic evaluation of women with
• Age range-47-91 yrs
Conclusions
• 10% of women with thickened endometrium turned
out to have endometrial cancer this correlates to
the international observational studies.
• 56% of women with suspected endometrial polyps
were confirmed by hysteroscopy.
• None of the women with endometrial thickness less
than 4 mm found to have carcinoma.
• Ten women were diagnosed with endometrial cancer
(10% incidence).
• Three had cervical cancer.
• Seven women were diagnosed with complex hyperplasia
abdominal hysterectomy and bilateral salphingo
in the initial pipelle sample, of which endometrial cancer
oophorectomy.
was present in 4 women.
• 21 patient had sonographic findings suggestive of
postmenopausal vaginal bleeding is exclusion of malignancy.
postmenopausal women with vaginal bleeding.
• 56 clinics
• 13 patients were HRT users
• 10% of symptomatic women with thickened endometrium will
• Transvaginal ultrasound is a cost-minimizing screening tool for
Results
…
endometrial polyp of which 12 confirmed by the gold
standard (hysteroscopy) (57%)
• Endometrial polyps are often diagnosed with transvaginal
ultrasonography while in some occasions it might be bit
difficult.
• Saline sonography helps in the better detection of endometrial
polyps.
References
Aim
• To ascertain the pick up rate of endometrial cancer in women
attended the Post Menopausal Bleeding clinic with
Postmenopausal bleeding and thickened endometrium.
• To ascertain the prevalence of other pathology (polyps) in the
same cohort of women
TEMPLATE DESIGN © 2008
www.PosterPresentations.com
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• Transvaginal sonography combined with saline contrast
sonohysterography to evaluate the uterine cavity in patients
with abnormal uterine bleeding and postmenopausal
endometrium more than 5 mm. Kazandi M, Akşehirli S, Cirpan
T, Akercan F. Eur J Gynaecol Oncol. 2003; 24(2):185-90.
• Endometrial polyps in postmenopausal women.
• Domingues AP, Lopes H, Dias I, De Oliveira CF. Acta Obstet
Gynecol Scand. 2009; 88(5):618-20.
…