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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Ultrasound Shows Thickened Endometrial Stripe. Necessary To Do D&C?

I am 66 years old and have gone thru menopause . I had a pap test that was normal. I had an ultra sound that measured my endometrial stripe at 1.7 cm. My gyn did an endometrial biopsy which came back normal. Now she wants to do a D and C because of the endometrial stripe is thickened for my age. Is this necessary. Is there a risk for endometrial cancer?
Mon, 16 Sep 2013
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OBGYN 's  Response
Hi,
Thanks for writing in.
I agree that your endometrial thickness is too much. Your doctor is rightly concerned & has done a good thing to biopsy your endometrium.
This is quite reassuring that your endometrial biopsy is normal This test samples a small fraction of endometrium & is less sensitive then a Hysteroscopy & diagnostic D&C. This I think is the ideal investigation in your case.
There is a very small risk of endometrial cancer, but a diagnosis of polyp is more likely.
Hope this clears your query.
Take care.
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OBGYN Dr. Bryan J Treacy MD's  Response
Thanks for your question. Your doctor is absolutely on the right track. The endometrial stripe on ultrasound should be less than 0.5 cm during menopause. A 0.5cm or greater endometrial stripe on ultrasound is an indication for biopsy. Unfortunately, an office biopsy may be negative in up to 40% of women who really have pathology. The gold standard for evaluation is a hysteroscopy with D&C to make sure no pathology is missed. Many times, the thickness is due to a benign polyp, but endometrial cancer is a risk in this situation. Make sure to follow through with your recommendations until you can be sure that endometrial cancer is not present.
I hope this answers your questions but I am available for further consultation if needed.
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Ultrasound Shows Thickened Endometrial Stripe. Necessary To Do D&C?

Hi, Thanks for writing in. I agree that your endometrial thickness is too much. Your doctor is rightly concerned & has done a good thing to biopsy your endometrium. This is quite reassuring that your endometrial biopsy is normal This test samples a small fraction of endometrium & is less sensitive then a Hysteroscopy & diagnostic D&C. This I think is the ideal investigation in your case. There is a very small risk of endometrial cancer, but a diagnosis of polyp is more likely. Hope this clears your query. Take care.