Asymptomatic endometrial thickening in postmenopausal women: predictor of malignant pathology?
Creators: name: García, Alba María Cruz
name: Morales, Elena Pérez
name: Padrón, Ludmila Ocón
name: Matos, Cristina Pérez
name: Suárez, Alejandra Santana
name: Zrihen, Yonit Emergui
name: Naya, María Ángeles Nieto
name: Sánchez, Victoria Sánchez
name: Martínez, Alicia Martín
Publisher: name: Taylor & Francis
Year: 2022
Subjects: subject: Biophysics
subject: Physical Sciences not elsewhere classified
subject: Medicine
subject: Cell Biology
subject: Physiology
subject: FOS: Biological sciences
subject: Biotechnology
subject: Mathematical Sciences not elsewhere classified
subject: Cancer
subject: Mental Health
subject: Hematology

description: It is not standardised what is the endometrial thickness that discriminates between normal and potentially malignant. The objective of this study was to determine the endometrial thickness cut-off point from which the risk of endometrial cancer (EC) increases in asymptomatic postmenopausal women; and to evaluate the risk factors linked to malignant endometrial pathology as well as other associated ultrasound findings. This was a retrospective observational study that included hysteroscopies performed at the Hospital Materno-Infantil on 267 asymptomatic menopausal women with an increase in endometrial thickness (AET) &gt;5 mm, from 2015 to 2019. The results shows that the prevalence of malignant pathology in asymptomatic postmenopausal women with a casual finding of endometrial thickening was 3.7%. This percentage was 16.3% when the cut-off point of AET was established at 10 mm. There was a significant association for the diagnosis of malignant pathology with this cut-off point. There is a significant association between the 10 mm endometrial thickness cut-off point from which the risk of EC increases in asymptomatic postmenopausal women.Impact statement<b>What is already known on this subject?</b> Several studies have established the cut-off point for asymptomatic endometrial thickening (AET) for atypical endometrial hyperplasia and endometrial cancer at 10 mm. Although no cut-off point has optimal accuracy for the diagnosis of malignant endometrial pathology, it has been found that with a cut-off value of AET &gt;10 mm no cases are missed. Likewise, a cut-off point of AET &gt; 11 mm may provide a balance between cancer detection and histopathological workup extension.<b>What do the results of this study add?</b> A significant association was found at the cut-off point of AET &gt; 10 mm, which suggests that screening postmenopausal women at this thickness is acceptable and unlikely to miss cases of endometrial hyperplasia and endometrial cancer.<b>What are the implications of these findings for clinical practice and/or further research?</b> After analysing our results we can conclude, like other published studies, that by establishing a cut-off point of 10 mm we obtain a good discrimination between benign and malignant pathology, which would allow us to diagnose 100% of malignant pathology. Above this cut-off point, the risk of endometrial cancer increases, and it would therefore be advisable to extend the study. A multicentre study is needed to confirm the cut-off point at which the risk of endometrial cancer increases in postmenopausal women with asymptomatic endometrial thickening. <b>What is already known on this subject?</b> Several studies have established the cut-off point for asymptomatic endometrial thickening (AET) for atypical endometrial hyperplasia and endometrial cancer at 10 mm. Although no cut-off point has optimal accuracy for the diagnosis of malignant endometrial pathology, it has been found that with a cut-off value of AET &gt;10 mm no cases are missed. Likewise, a cut-off point of AET &gt; 11 mm may provide a balance between cancer detection and histopathological workup extension. <b>What do the results of this study add?</b> A significant association was found at the cut-off point of AET &gt; 10 mm, which suggests that screening postmenopausal women at this thickness is acceptable and unlikely to miss cases of endometrial hyperplasia and endometrial cancer. <b>What are the implications of these findings for clinical practice and/or further research?</b> After analysing our results we can conclude, like other published studies, that by establishing a cut-off point of 10 mm we obtain a good discrimination between benign and malignant pathology, which would allow us to diagnose 100% of malignant pathology. Above this cut-off point, the risk of endometrial cancer increases, and it would therefore be advisable to extend the study. A multicentre study is needed to confirm the cut-off point at which the risk of endometrial cancer increases in postmenopausal women with asymptomatic endometrial thickening.