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International Journal of Surgical Oncology
Volume 2016, Article ID 3039261, 5 pages
Research Article

A Structured Assessment to Decrease the Amount of Inconclusive Endometrial Biopsies in Women with Postmenopausal Bleeding

1Department of Obstetrics and Gynecology, Erasmus MC Cancer Institute, Postbus 2040, 3000 CA Rotterdam, Netherlands
2Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, Postbus 444, 3300 AK Dordrecht, Netherlands
3Department of Pathology, Radboud University Medical Center, Postbus 9101, 6500 HB Nijmegen, Netherlands
4Department of Obstetrics and Gynecology, Academic Medical Center, Postbus 22660, 1100 DD Amsterdam, Netherlands
5Department of Obstetrics and Gynecology, Maastricht University Medical Center, Postbus 5800, 6202 AZ Maastricht, Netherlands
6Department of Pathology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, 5022 GC Tilburg, Netherlands
7Clinical Research Unit, Academic Medical Center, Postbus 22660, 1100 DD Amsterdam, Netherlands
8The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide and South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
9Department of Obstetrics and Gynecology, TweeSteden Hospital, Dr. Deelenlaan 5, 5042 AD Tilburg, Netherlands

Received 30 October 2015; Revised 19 January 2016; Accepted 8 February 2016

Academic Editor: Rajendra A. Badwe

Copyright © 2016 M. C. Breijer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To determine whether structured assessment of outpatient endometrial biopsies decreases the number of inconclusive samples. Design. Retrospective cohort study. Setting. Single hospital pathology laboratory. Population. Endometrial biopsy samples of 66 women with postmenopausal bleeding, collected during the usual diagnostic work-up and assessed as insufficient for a reliable histological diagnosis. Methods. Endometrial biopsy samples were requested from the pathology laboratories. The retrieved samples were systematically reassessed by a single pathologist specialized in gynecology. Main Outcome Measure. Disagreement between initial assessment and conclusion after structured reassessment. Results. We retrieved 36 of 66 endometrial biopsy samples from six different pathology laboratories. Structured reassessment of the retrieved samples by a single pathologist specialized in gynecology did not change the conclusion in 35 of the 36 samples. The remaining sample contained a large amount of endometrial tissue and the diagnosis at reassessment was endometrial hyperplasia without atypia. All other samples contained insufficient material for a reliable diagnosis. Conclusion. A structured reassessment of endometrial biopsies samples, which were classified as inconclusive due to insufficient material, did not change the conclusion. Although it might be helpful for pathologists to have diagnostic criteria for adequacy and/or inadequacy of an endometrial biopsy sample, the gain in efficiency is likely to be small.