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Is Biopsy Required Before Surgical Removal Of The Uterus To Diagnose The Cause Of Post Menopause Bleeding?

Posted on Fri, 7 Sep 2018

Question: My mother aged 66 years has been advised removal of uterus due to problem of post menopause bleeding. She entered in to menopause in 1992 and in 2004 she observed minor bleeding. Then she was investigated with biopsy and nothing was found at that time.
Now 7 days back she suffered heavy bleeding like menstrual cycle. She was advised some tests including sonography by the Gynaecologist (Reports are attached) .
On the basis of reports, Doctor has advised removal of uterus. I want to know the course of action like
1. if biopsy is required before the surgery or we can go for surgery directly?
2. If biopsy is required, then why?
3. Whether there is any chance of cancer in any part?If yes then is there any chance of cancer getting worsened if uterus is removed?
Please advise.

Answered by Dr. Deepti Verma (30 minutes later)

Brief Answer:
Please upload the reports

Detailed Answer:
Hi,
I have gone through your question and understand the concerns.
Please upload the reports so that I can help solve your queries.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepti Verma (12 minutes later)

reports are attached

Answered by Dr. Deepti Verma (12 hours later)

Brief Answer:
Biopsy advised

Detailed Answer:
Hi,
I have reviewed the reports and the prescription.
The uterine lining or the endometrium is thickened and it can be malignancy.
So, an endometrial biopsy Should be done to confirm the diagnosis.
If malignant, then further investigations like MRI is required and the surgery or radiotherapy should be planned accordingly.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Deepti Verma (2 days later)

As suggested biopsy samples were collected today and sent to lab whose reports are expected by 7th February. CT scan has also been done today (report attached). please review and suggest further course of action. is there a chance of cancer? if yes , can we determine the stage as of now? how serious is this case ? please reply,we are very much worried. CT scan results are attached.

Answered by Dr. Deepti Verma (10 hours later)

Brief Answer:
MRI and surgical staging

Detailed Answer:
Hi,
I have reviewed the CAT scan report and the findings are suggestive of endometrial cancer.
Stage cannot be assessed by CT scan.
A MRI and surgery should be done to assess the stage, if malignancy is confirmed, and further management should be done accordingly.
You can get back to me with the reports.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Deepti Verma (3 days later)

Biopsy report is attached. please suggest further course of action. can we go for surgery by any experienced Gynecologist or Oncologist.

Answered by Dr. Deepti Verma (22 hours later)

Brief Answer:
Malignancy ruled out, can go for surgery

Detailed Answer:
Hi,
I have gone through the report.
It shows proliferative endometrium, which is a hormonal imbalance.
This is not a malignant condition.
You can go for surgery by any experienced gynecologist.

Take care,
Dr Deepti Verma, OBGYN, Maternal and Fetal Medicine

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj