Diagnosis
In patients who are suspected of having endometrial carcinoma, clinicians should obtain:
- a detailed account of the presenting symptoms
- complete drug history e.g. - HRT, oral contraceptive pill, tamoxifen
- a gynaecological history to find out about early menarche/late menopause, known endometrial hyperplasia, parity
- medical and surgical history - obesity, treatment for breast cancer, diabetes mellitus, hypothyroidism, hypertension, and Lynch-type syndrome (1)
General practitioners in the UK should refer women with postmenopausal bleeding to a rapid access gynaecology clinic to be seen within two weeks.
The following patients should be referred to a gynaecologist to rule out other possible sources of vaginal bleeding
- premenopausal patient older than 40 years who presents with a recent onset abnormal bleeding pattern
- a premenopausal patient of any age with an abnormal bleeding pattern and risk factors for endometrial cancer
A definitive diagnosis is made histologically through a tissue sample obtained either by a Pipelle curette (as an outpatient procedure) or by hysteroscopy and dilatation and curettage under general anaesthesia.
Patients who are confirmed of having endometrial cancer should be referred to a specialised gynaecology oncological centre for further evaluation (1).
Reference:
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