The profile of patients with endometrial cancer: analysis of clinical and radiological signs

Abstract

Introduction: Endometrial cancer (EC) is the fourth most common cancer in women. Screening for EC is not recommended. Its investigation begins with abnormal uterine bleeding and its initial examination is transvaginal ultrasound, which looks for endometrial thickening and whether a biopsy is necessary to confirm the diagnosis. Histological assessment of the endometrial tissue can be carried out on an outpatient basis or by video-hysteroscopy. Objective: To analyze the clinical signs and alterations in imaging tests that led to the suspicion and diagnosis of EC. Method: Cross-sectional study carried out over 7 months, analyzing the medical records of patients diagnosed with endometrial cancer after video-hysteroscopy. Results:  Of the 4,129 medical records examined, 50 (1.2%) patients were diagnosed with EC. Of these, 47 (94%) were over 54 years old, 47 (94%) were in menopause and 26 (52%) were overweight or obese. As for clinical presentation, 39 (78%) reported abnormal uterine bleeding as their main complaint. In addition, transvaginal ultrasound findings showed an average of 14.85mm of endometrial thickening, but it is important to note that 6 (12%) patients had a thickness < 4mm, which for many guidelines would not require further investigation with pathology. Conclusion: The results emphasize the ongoing challenge of diagnosing EC. The detection of EC in postmenopausal women with discrete thickening underscores the importance of an individualized assessment and indication for expanded propaedeutics. It also highlights the importance of conducting further studies on the subject.