Abnormal Uterine Bleeding in Ten Minutes or Less
Channel: CedarsSinaiOBGYN
Date: 2011-06-26

diagnostic hysteroscopy and endometrial cancer: two camps (no one is wrong, you will see attendings do both)

#1 Camp - if I have someone who has cervical stenosis and I can't get an EMB in the office, then I am going to do a "blind" D&C in the OR, because I'm afraid of "pushing" cancer cells into the periotoneal cavity (this has been proven to be true, as cited in the video) despite hysteroscopy/D&C being the gold standard

#2 Camp - a diagnostic hysteroscopy is the gold standard, thus i'm doing a visually directed biopsy, and I know what endometrial cancer looks like.  But even if I push endometrial cancerous cells into the peritoneal cavity, it won't worsen prognosis, since the latest staging guidelines for endometrial cancer discovered positive "washings" didn't worsen prognosis.  (Now Gyn Oncology doesn't even do pelvic "washings" in an endometrial cancer case, unless there is an adnexal mass and the possibility of a synchronous ovarian malignancy).