Endometrial cancer

Question 1

What are the differential diagnosis for post menopausal bleeding?

Answer 1

1. HRT
2. Endometrial hyperplasia / carcinoma / polyps
3. Cervical cancer / polyps
4. Vulval / Vaginal / Ovarian cancer
5. Vaginal atrophy

Question 2

When should direct access USS be done in women aged > 55 years?

Answer 2

1. Unexplained PV discharge presenting for the first time
OR
Thrombocytosis
OR
haematuria

2. Visible haematuria AND
   - Thrombocytosis
   or
   -Anaemia
   or
   - Raised blood glucose

Question 3

What investigations are performed in fast track clinic?

Answer 3

1. Transvaginal ultrasound
2. Endometrial biopsy - for histology
3. Hysteroscopy or biospy

Question 4

What is the threshold thickness for endometrial cancer in mm?

Answer 4

< 5 mm has negative predictive value of 98%