Many women have been told they need a uterine or endometrial biopsy for diagnosis purposes. Do not do so. Blind endometrial biopsies became very popular in the early 1990’s and became the standard of care after a report said they were 97.5% accurate. Before that women had Dilation and Curettage (D&C) or a scraping that was done under anaesthesia. Both of these are painful, invasive, procedures that cause women a lot of discomfort and needless pain.
In 1995 a well-known study showed that for women with cancer who had a biopsy in the operating room, the biopsy missed 11 out of 65 of those cancers, (16.9%). However, when they cut open those uteri they found that the cancer occupied less than half of the surface area of those uteri.
Dr Goldstein, an expert gynecologist in Manhattan, lectured on this since 1995, but in 2012 the ACOG finally put in their practice bulletins that when these biopsies are negative, it is not a stopping point. Unfortunately, the majority of practicing gynecologists do not know this and continue to do a biopsy as their first choice. Studies have shown these gynecologists are very likely to miss the abnormality with a blind biopsy.
Instead, a saline infusion sonogram, where some fluid is put into the uterus allows the operator to see better and produce clear, high-resolution images of the entire uterus. If you’ve been told that you need a uterine biopsy for diagnosis, ask first for a saline infusion sonogram, a painless, non-invasive procedure which is performed right in the office in a few minutes.
Dr Steven R. Goldstein is one of the best gynecologists in Manhattan and is well known internationally for ground breaking work in gynaecological ultrasound and imaging. He is a Professor of Obstetrics and Gynecology at New York School of Medicine, served as Director of Gynecologic Ultrasound at New York University Medical Center and is a former President of the American Institute of Ultrasound in Medicine.
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