{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:47:15Z","timestamp":1785577635482,"version":"3.56.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>To determine the rate of precancer and cancer in women presenting with PMB who have a visually atrophic endometrium at hysteroscopy and assess the value of endometrial biopsy in this situation and the adequacy of the samples obtained.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Retrospective reviews of all patients with a visually atrophic endometrium at hysteroscopy who had presented with PMB and had an ET\u2009&gt;\u2009\/\u2009=\u20094\u00a0mm or ET\u2009&lt;\u20094\u00a0mm with focal changes or irregular features between 2013 and 2024 at University Hospitals of Derby and Burton were included (<jats:italic>n<\/jats:italic>\u2009=\u20091096). Patients who had previously had cancer or precancer or had unclear hysteroscopy findings were excluded. The endometrial biopsy histology result was considered the main outcome measure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>188 patients did not have a biopsy performed (17.15%), 660 patients had benign pathology (60.22%), and 239 patients had an inadequate sample result (21.81%). Nine patients had precancerous changes (0.82%). The rate of cancer was 0.00% (<jats:italic>n<\/jats:italic>\u2009=\u20090). The NPV of a visually atrophic endometrial cavity at hysteroscopy in detecting precancer or cancer was 99.2%. Patients with an ET\u2009&lt;\u20094\u00a0mm pre-hysteroscopy and an atrophic endometrial cavity at hysteroscopy were 2.25 times more likely than those whose ET is\u2009&gt;\u20094\u00a0mm to have an inadequate sample (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, 95% CI 1.61\u20133.16). 10 patients who had an inadequate sample at initial biopsy had a repeat inadequate sample (<jats:italic>n<\/jats:italic>\u2009=\u200923, 43.48%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The incidence of precancer\/cancer in patients presenting with PMB with a visually atrophic endometrium at hysteroscopy is low. Many patients within this cohort have an inadequate sample at biopsy, and therefore, repeat sampling is of questionable value.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00404-024-07922-3","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T18:26:20Z","timestamp":1737397580000},"page":"1127-1132","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Value of endometrial biopsy in patients with hysteroscopically atrophic endometrium in patients with postmenopausal bleeding"],"prefix":"10.1007","volume":"311","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1011-6253","authenticated-orcid":false,"given":"Ayisha A.","family":"Ashmore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abayomi I.","family":"Alao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amie","family":"Hibbard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libbi","family":"Burchnall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Menic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Summi","family":"Abdul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viren","family":"Asher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anish","family":"Bali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Kolhe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"7922_CR1","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.ejogrb.2021.11.423","volume":"270","author":"J Morrison","year":"2022","unstructured":"Morrison J, Balega J, Buckley L et al (2022) British gynaecological cancer society (BGCS) uterine cancer guidelines: recommendations for practice. 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