Ultrasound or biopsy for evaluation of endometrium? It depends

Biopsy isn’t usually the first step in evaluating the endometrium of a reproductive-age woman who presents with abnormal uterine bleeding, but that’s not always the case, according to James M. Shwayder, MD.

[@MissTXTee]

Wow! Great information and it helped me better understand why my doctor has ordered both an ultrasound and biopsy.

[@cooperdog9956]

Blind biopsy is no longer considered the standard of care. So why are they done when they are unreliable and provide small sampling of the endometrium?

[@jacqieustioneverythingsmit5323]

I had a biopsy last November and result endometrial cancer , stage 1b , total hysterectomy in Jan 19, histology downgraded it to stage 1a, tumor grade 3 , I was offered brachytherapy , but refused it because I do not want my vagina scarred from radiation , oncologist said only a small risk of it returning . It won't return. Amen

[@noreenbalfe2594]

Why is sedation not mandatory for an endometrial biopsy?

[@collarclatch6414]

From what I am hearing from women, it should be. At the very least they should get a numbing agent applied to the cervix. My friend said it was the most painful thing she ever experienced . Mine is being done in two weeks, unless they refuse me some pain relief, in which case I will ask for hysto.

[@noreenbalfe2594]

@@collarclatch6414 There is a human right to receive pain management for endometrial biopsy so you just have to ask. If you have pain medication at home then definitely bring it with you. Advil and Tylenol don’t work. Also, have a plan in place with your doctor that you will raise your hand to signal stopping the procedure if its too painful.

[@collarclatch6414]

@@noreenbalfe2594 I agree with you. I called the office and asked the nurse if they would numb the cervix, she said she wasnt sure but would ask the Dr. I had said to her that I would like to skip the biopsy based on what I heard about it, and go right to hystorectomy since I am in my 60's. She calls back and says NO. Doc said to take Aleve before coming in. Also said I had to have the biopsy before any hysterectomy would be considered. I have had pain and occaisional bleeding for about a year. I have family history of cancer and risk factors like diabetes. The other gyno in my town will not take Medicare. So I am screwed.

[@noreenbalfe2594]

Medical institutions are well aware that the endometrial biopsy can trigger a vasovagal reaction which is sudden dizziness, or fainting that can be triggered by pain, fright, or trauma. You may sweat, feel light-headed, nauseated, or tingly, and you may pass out if the reaction continues. Make sure someone accompanies you and discuss with your doctor the real possibility of not being able to get out of bed for 6 weeks.

[@Youtubedisco]

I had biopsy in office. Minimal pain. But I've a friend who thought it was painful

[@janetwillits1066]

So I had an ultrasound and my endometrium is 15mm.. I am on HRT and I did have a biopsy that didnt have enough tissue.. Going for another biopsy.. My endometrium is also Heterogenious.. Is this something to worry about?????

[@futurenasascientist2473]

NOW WHAT HAS HAPPENED ???

[@cyanidecupcake231]

I'm having the same problems. Mine is 16mm thick and hetrogenous and I have a fibroid and cysts.

[@jacqieustioneverythingsmit5323]

@@cyanidecupcake231 How did you get on , what was the outcome ?

[@cyanidecupcake231]

@@jacqieustioneverythingsmit5323 well they actually changed my procedure to a hysteroscopy and D&C bc I didn't want to be awake for the procedure of the endometrium biopsy. They had found polyps and removed everything that was the problem. I actually just had my procedure last month. It took a very long time to get it done. I had to wait because I kept asking to be put to sleep. They really want women to stay awake. I think it's wrong.

[@jacqieustioneverythingsmit5323]

@@cyanidecupcake231 That's good news , are you recovered now ? Mine was cancer I had it all removed 10 weeks ago . I had my biopsy under GA .

[@believensee8621]

An ultrasound is significantly less painful for a woman than an endometrial biospy. In fact, it is not painful at all. Why would women be subjected to the most painful option as a first step?

[@Lexilea68]

Very informative. Thank you sir.

[@2busysecretary]

Both my biopsy and ultrasound said no cancer. Because the bleeding did not stop I had a hysterectomy and I was told then I had uterine cancer.

[@debdeepdas8376]

Is your cancer cured now after the hysterectomy?

[@2busysecretary]

@@debdeepdas8376 Yes, thankfully so, over three years cancer free

[@debdeepdas8376]

Sending you a bigggggg hug.

[@debdeepdas8376]

Also what results did you have in your initial USG test? Was it only thickened endometrium? Did you have a tumor?

[@2busysecretary]

@@debdeepdas8376 Everything looked fine... until during surgery then they determined I had cancer. Ultrasound showed only thickened lining. I actually had a large cancer tumor almost through the uterine wall. I'm so thankful I'm fine today.

[@hluvv7607]

I had ultrasound done found large fibroid and my doctor wants to do biopsy, I just want hysterectomy get it over with,

[@futurenasascientist2473]

ARE U FYN NOW...WHAT HAPPENED AFTER THAT?

[@island661]

Omg a hysterectomy? Wow extreme

[@jacqieustioneverythingsmit5323]

@@island661 it saves having to go back again and having the barbaric biopsy procedure done .In this day and age , you'd think there would be a painless procedure, there probably is but they won't use it .

[@jacqieustioneverythingsmit5323]

@@island661 I had hysterectomy because of cancer , no more pain no more bleeding .