Sonographic Evaluation of Endometrial Thickness in Postmenopausal Women- A Systemic Review

Abstract

Postmenopausal bleeding (PMB) is highly suspicious of being a sign for the presence of endometrial cancer (EC) and around 5–12% of PMB results from EC. Endometrial cancer is the most common gynecologic malignancy in developed countries. A thin endometrium (≤4 mm) has a very high negative predictive value (99%). A thickened endometrium has been regarded as an indication for an invasive evaluation. Endometrial sampling is recommended, with a cutoff value of 4 mm or 5 mm, for symptomatic postmenopausal women. However, different guidelines use different cut-off values of endometrial thickness, varying from 3 mm-5 mm, for excluding endometrial malignancy.

The widespread use of sonography has also allowed the incidental finding of endometrial thickening in asymptomatic postmenopausal women. There are few data on the workup of these women, and the best cut-off value for the endometrial thickness that should warrant endometrial sampling is not known. However, it has been suggested that the 4‐ or 5‐mm limits generally used for excluding malignancy in symptomatic postmenopausal women are not transferable to asymptomatic patients. The objective of this study was to sonographic evaluation of endometrial thickness in postmenopausal women. About 9 studies were selected for this systemic review. We extracted the following information: Study design, Age of patient mean and range, Duration of menopause mean and range, Body mass index mean and range, and Endometrial thickness mean and range. From the above analysis we concluded that, the endometrial thickness with a recommended change in the cut-off to 3mm in routine ultrasound practice should be done in high risk women to detect malignancy earlier in postmenopausal women and ultrasound is proved to be a useful tool for the disgnostic purpose.

Keywords: Postmenopausal bleeding, Endometrial  thickness, Endometrial Carcinoma.

DOI: 10.7176/JHMN/82-04

Publication date: November 30^th 2020