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Re: liability of US Endometrial Thickness From: art fougner, md (evsono@pipeline.com) Wed Mar 22 07:35:18 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: RModugno@aol.com: "Re: Fast orgasm" Previous message: Robert J. Woolley: "Re: Fast orgasm" In reply to: Joanne Bulley, MD: "Re: liability of US Endometrial Thickness" Next in thread: Gordon: "Re: Reliability of US Endometrial Thickness" As i stated before - there truly is no good answer here, similar to why the woman with normal baby has an abnormal Down's syndrome screen. The ultrasound literature does not satisfactorily address your concern. what may be happening is that something in this patient's subendometrial uterine wall, eg adenomyosis, produces an increased echogenicity similar to a thickened endometrium. this, in fact, is NOT an unusual finding in the tamoxifen - treated woman, for whom Goldstein would suggest a sonohysterogram prior to sampling. of course, this is not the situation for your patient, nor was saline infusion an option in the setting of cervical stenosis. Carlos - we are saying the same - ultrasound EM > 5mm does NOT mean path. However, it does NOT exclude path. the default is still histology. Harrison and Garry, locally, a woman was presented at tumor board with an endometrial carcinoma which apparently developed while she was taking tamoxifen. she had no previous ultrasounds and a pipelle six months previously was reported as negative. Art At Tue, 21 Mar 2000, Joanne Bulley, MD wrote: > >Yes - Carlos - my QUESTION is - what is being seen on the US when I >can't even scrape off a 2 mm thick sample endometrium??? I absolutely >agree - the US is helping decide who NOT to biopsy. Especially in the >woman who has a tiny post menopausal os that will be hard to traverse. I >expect mosy biopsies or D&C's for 6-10mm endometrial double stripes to >be negative for malignancy. But WHY was it even 9mm when I couldn't get >any tissue with vigorous scraping? >Joanne > >>>Joanne - >>> >>>definitely sounds like a false positive to me. when Goldstein first >>>suggested the 5 mm as a cut-off in the other direction - in other words, >> >>Art, you have it right up to here. If less than 5mm no cancer and thus >>no need for reflex biopsy. If MORE than 5 it doesn't mean there is >>pathology but it doesn't mean any more that there isn't pathology so the >>reflex biopsy is still on. Most will be negative anyway. >>As for the original post, I have no idea why a thickness of 9mm occurs >>with atrophic endometrium as in this case. any answer to the original >>Dr. Bulley's question?? >> >>Carlos > >-- >Joanne Bulley, MD >Keene, NH, USA > -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: RModugno@aol.com: "Re: Fast orgasm" Previous message: Robert J. Woolley: "Re: Fast orgasm" In reply to: Joanne Bulley, MD: "Re: liability of US Endometrial Thickness" Next in thread: Gordon: "Re: Reliability of US Endometrial Thickness"

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