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TVS & endometrial CaFrom: art fougner, md (evsono@pipeline.com)Tue Jan 12 07:16:22 1999
This just in - Ultrasound said to offer painless uterine-cancer detection December 17, 1998 By Linda Carroll c. 1998 Medical Tribune A simple ultrasound scan may be better at detecting cancer of the uterus than the traditional biopsy method, researchers reported. After scrutinizing data from more than 5,000 women, California researchers concluded that doctors using ultrasound could detect 96% of uterine cancers in post-menopausal women who had complained of abnormal bleeding, according to a report in the Journal of the American Medical Association (1998;280:1510-1516). This is compared with 85% to 95% discovered through biopsy. Studies attempting to discover the prevalence of cancer in post-menopausal women with vaginal bleeding report widely varying rates-anywhere from 5% to 60%, noted the study's lead author, Rebecca Smith-Bindman, M.D., a researcher at the San Francisco Veterans Affairs Medical Center. Age differences can explain some of the variation, she added. To get a large enough sample of women, Dr. Smith-Bindman and her colleagues performed a meta-analysis of data from 35 older studies. Altogether, they examined records from 5,892 women who had been given an endovaginal ultrasound. The researchers found that 96% of the women with cancer had uterine linings that were thicker than 5 mm. A downside to the method is that 23% of women who took hormone-replacement therapy and did not have cancer turned out to have a lining thick enough to warrant further tests, including a biopsy. Still, the method turns up more cancers than biopsies performed in the doctor's office, Dr. Smith-Bindman concluded. "It is not surprising that endovaginal ultrasound misses fewer abnormalities than office-based endometrial biopsy because ultrasound allows visualization of the entire [uterine] cavity, whereas most biopsy techniques rely on blind sampling," she added. A physician not connected with the study agreed with its findings. "The cancers I've seen have all occurred in women with [lining] thickness in excess of 5 mm," said Morris Wortman, M.D., a clinical associate professor at the University of Rochester and director of the Center for Menstrual Disorders and Reproductive Choice, both in Rochester, N.Y. thought you'd all like to know. Art
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
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