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Dr. Andrew Rynne

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Getting brown discharge. Transvaginal ultrasound showed endometrium measuring 0.7. What should I do?

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Dr. Raju A.T

General & Family Physician

Practicing since :2008

Answered : 3756 Questions

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Posted on Tue, 11 Dec 2012 in Women's Health
Question: HI....I WAS HOPING TO HAVE THIS QUESTION ANSWERED BY DR. XXXXXXX A.T. BECAUSE HE WANTED ME TO CONTACT HIM AFTER THE RESULTS OF MY ENDOMETRIAL BIOPSY SO WE CAN DISCUSS THINGS FURTHER.....MY BIOPSY RESULTS WERE BENIGN BUT INCONCLUSIVE....HOW CAN THAT BE..COULD IT BE TO THE FACT THAT THE RESULTS ARE STILL NOT SAYING WHY I AM GETTING BROWN DISCHARGE OCCASIONALLY AND I AM EITHER PERI OR POST MENOPAUSAL....MY TRANSVAGINAL ULTRASOUND SHOWED MY ENDOMETRIUM MEASURING 0.7...NOW MY GYNE WANTS TO DO A D&C AND AN HYSTEROSCOPY...SHOULDN'T A BIOPSY BE SUFFICIENT....WHAT IS YOUR OPINION ON THIS....THANK YOU SO MUCH & ANXIOUSLY AWAITING TO HEAR FROM YOU.
doctor
Answered by Dr. Raju A.T 10 hours later
Hi,

Thanks for your query.

Yes, rarely the biopsy does fail to provide convincing results,this happens more in postmenopausal patients.The endometrium is usually uneven in menopausal women.Hence, there are possibilities for a biopsy to be conclusive.

Your doctor is right in planning for a Dilatation and curettage (D&C) with an Hysteroscopy.These are tests which do provide the required information to arrive at the diagnosis if the biopsy fails.

Do proceed for the above procedures. Infact D&C also is considered as therapeutic procedure, it can correct the brown discharge specially in post menopausal women by removing the abnormal endometrium.

Hope I answered your query.Please do ask doubts, if any.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Raju A.T 9 hours later
HELLO DR. XXXXXXX A.T.

THANK YOU FOR YOUR ADVICE....I THOUGHT THAT AN ENDOMETRIAL BIOPSY WAS GOLD IN DETECTING EVEN THE EARLIEST CANCER, THAT IS WHAT YOU MENTIONED TO ME PREVIOUSLY....MY RESULTS BEING BENIGN BUT INCONCLUSIVE, IS THAT SAYING IT IS NOT SURE IF THERE ARE CANCER CELLS PRESENT.....I AM VERY CONFUSED ABOUT MY RESULTS....I THOUGHT WHEN A BIOPSY WAS BENIGN THEN THAT MEANT YOU HAVE NO CANCER.....WHAT WOULD BE THE CHANCES OF MY BIOPSY BEING BENIGN, UNDER GOING THE D&C & HYSTEROSCOPY AND HAVING ENDOMETRIAL CANCER....ANXIOUSLY AWAITING TO HEAR FROM YOU...THANK YOU SO MUCH!!!
doctor
Answered by Dr. Raju A.T 11 hours later
Hi,

Thanks for writing back. I understand your concern and I shall address this in 2 points.

1. You need not worry. Biopsy is a procedure where the endometrium (lining of the uterine cavity) is taken and studied under microscope. This study involves identifying the cancer cells, hence it is very reliable and a gold standard test to identify cancer.
The Biopsy test you underwent says the cellularity though not 100% conclusive does show signs of benign nature. Therefore I would consider the chances of cancer in you to be very negligible.

2. The adequacy of a good sample is also a factor important in determining the success of the biopsy test to identify the cancer.

In menopausal/perimenopausal women, as the endometrial lining is usually uneven a simple biopsy sometimes may not yield good sample. Hence when a biopsy procedure fails to obtain a good sample, D&C where most of the endometrial lining is removed and then studies under microscope, follows.

Therefore the difference between the biopsy and the D&C is only the sample size. Also D&C has therapeutic effects as I mentioned in my previous post. When Hysteroscopy is added to D&C it rules out lot many other conditions like fibroids, adhesions, structural deformations, etc.

Hence I agree with your doctor’s recommendation. Nevertheless you can stay relaxed.

Hope I have addressed your concern. Yet, I will be available to help you if you have other concerns.

Wish you good health...

Regards,

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Raju A.T 3 hours later
HELLO DR.

THANK YOU SO MUCH FOR CLARIFYING THINGS UP BUT I STILL HAVE A CONCERN....IF THE BIOPSY ISN'T 100% RELIABLE, THEN WHY SHOULD I HAVE BEEN PUT THROUGH THAT, WHY WASN'T THE TRANSABDOMINAL & TRANSVAGINAL ULTRASOUND CANCELLED AND ALSO THE BIOPSY NOT PERFORMED, I DON'T UNDERSTAND THAT....I KNOW YOU CAN'T PREDICT THE FUTURE, BUT MEDICALLY SPEAKING, WHAT ARE MY CHANCES OF HAVING ENDOMETRIAL CANCER HAVING A BENIGN BIOPSY....I AM SO WORRIED ABOUT THIS....IS IT A GOOD SIGN THAT MY TRANSVAGINAL ULTRASOUND WAS GOOD, MEANING IF THERE WAS CANCER, THE ULTRASOUND WAS NOT SHOWING ANY INVASION...AGAIN, THANK YOU SOOOOO MUCH.
doctor
Answered by Dr. Raju A.T 11 hours later
Hi again,

Endometrial biopsy test is a reliable test.The quality of the sample has very important role to play in the test outcome.As I mentioned above the sample sometimes in menopausal/postmenopausal women would not be optimum hence the test may fail to be conclusive.Whereas D&C involves scraping the major portion of the endometrial lining which can be subjected to microscopy.

Based on the Ultrasound findings and the biopsy findings which does say benign nature,I would consider the chances of cancer in you are negligible.Need not worry.

D&C may completely cure your brown discharge and also provide convincing results.

Regards,


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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