Diagnosis until proven otherwise for postmenopausal bleeding
Patient handout - Endometrial cancer - patient.co.uk
Clinical features
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Peak incidence 50-70yo
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Risk factors:
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age
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obestiy
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nulliparity
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late menopause
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diabetes mellitus
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polycystic ovary
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drugs
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unopposed oestrogen
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tamoxifen
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family history
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breast
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ovarian
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colon cancer
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Symptoms
80% present with abnormal bleeding
Especially post menopausal bleeding
Investigations
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Smear
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detects some cases
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not excluded by normal smear
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Ultrasound
- >12mm
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Pipelle
Management
Urgent gynae referral
NICE guidance
When woman who is not on fromone replacement therapy presents with postmenopausal bleeding g- urgen referral should be made
When a woman on hormone replacement therapy presents with persistent or unexplained post menopausal bleeding after cessation of hormone replacement therapy for 6 weeks - an urgent referral should be made
Tamoxifen can increase the risk of endometrial cancer