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Published in: Familial Cancer 3/2007

01-09-2007

Hysteroscopic findings in women at risk of HNPCC. Results of a prospective observational study

Authors: Fabrice Lécuru, Ulrike Metzger, Catherine Scarabin, Marie Aude Le Frère Belda, Sylviane Olschwang, Pierre Laurent Puig

Published in: Familial Cancer | Issue 3/2007

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Abstract

Objectives

To report the feasibility and results of diagnostic hysteroscopy in women at risk of HNPCC.

Methods

Fifty-seven women with mismatch repair gene mutations (n = 11) or Amsterdam II criteria (n = 46) were followed-up prospectively from January 1999 to March 2005. Flexible hysteroscopy was performed once a year. The endometrium was sampled routinely.

Results

Of 91 attempted hysteroscopies, 10 failed. The endometrial mucosa appeared normal in 34 cases. Polyps were seen in 12 cases, atrophy in 11, hypertrophy in 10, and fibroids in 7; two hysteroscopies suspected malignancy. A micropolypoid appearance was visualized during five hysteroscopies (5/81, 6%). Of the 86 endometrial biopsy attempts, 64 were successful and showed atrophy (n = 14), proliferation (n = 12), secretion (n = 27), polyps (n = 6), simple hyperplasia without atypia (n = 3), or cancer (n = 2). Micropolypoid appearance was not associated with a specific histological pattern. Operative hysteroscopy was done in 24 cases; in two patients with apparently benign focal lesions the results showed simple hyperplasia without atypias. Five patients underwent hysterectomy (simple hyperplasia without atypias, n = 2; endometrioid adenocarcinoma, n = 2; or secretory mucosa, n = 1). This study led to diagnosis of endometrial simple hyperplasia in 6% of cases and of cancer in 3%.

Conclusions

In patients at risk of HNPCC, hysteroscopy appears feasible to screen endometrial pathology. Two cancers have been diagnosed over 91 patient-years at risk. Hysteroscopy should be compared to sonography as a screening tool in women at risk of HNPCC.
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Metadata
Title
Hysteroscopic findings in women at risk of HNPCC. Results of a prospective observational study
Authors
Fabrice Lécuru
Ulrike Metzger
Catherine Scarabin
Marie Aude Le Frère Belda
Sylviane Olschwang
Pierre Laurent Puig
Publication date
01-09-2007
Publisher
Kluwer Academic Publishers
Published in
Familial Cancer / Issue 3/2007
Print ISSN: 1389-9600
Electronic ISSN: 1573-7292
DOI
https://doi.org/10.1007/s10689-007-9123-2

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