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Accuracy of transvaginal ultrasound

Rewriter's picture
Posts: 497
Joined: Dec 2009

I'm still trying to reassure myself and my friend that her postmenopausal bleeding is probably nothing. I know that I am posting on a site where, if we had postmenopausal bleeding, it WAS cancer. That's how my cancer presented itself.

However, I am quoting here from a cancer society website:

Transvaginal ultrasound is a noninvasive diagnostic tool commonly used to evaluate women with postmenopausal uterine bleeding. The ultrasound examination for endometrial pathology includes a measurement of endometrial thickness. In clinical studies, endometrial malignancy is uncommon in women with an endometrial thickness measurement <5 mm (1, 2).

My friend's endometrial thickness measurement was 4 mm. If a TVUS has high sensitivity, which I have read that it does, can we be somewhat reassured before her D&C? The doctor gave her the option of doing nothing, since the symptom was a one-time bleed on Thanksgiving night, but I talked my friend into pursuing this so as to be 100 percent sure.

Thanks for any input. Again, I am looking for any REASSURANCE I can get. I can and do imagine my own worst-case scenarios.

maggie_wilson's picture
Posts: 616
Joined: Nov 2009

unfortunately, my transvaginal ultrasound did not pick up my cancer, only a couple of fibroids and a cyst on my ovary. if i were she, i'd have the d and c, which it sounds like she's going to do. of course, it could be nothing, and that's what we'll hope for.

Rewriter's picture
Posts: 497
Joined: Dec 2009

Thank you, Maggie, for taking the time to answer. I have been following all of your posts and certainly wish you a serene and joyful time at Commonweal...before your return to the world of tests and more tests.

May I ask if your endometrial stripe was of normal thickness? That seems to be what our key reassurance is...that the stripe was under a certain cutoff point that meant that a diagnosis of cancer is very unlikely. Various Internet sites say that the TVUS has 97 percent sensitivity.

Yes, Marie will have the D&C, which we feel if the most definitive test, but both of us are inordinately terrified. M was my partner for 14 years and is still the closest person I have to family. I want her to be well and unafraid.

kkstef's picture
Posts: 706
Joined: May 2008

My experience was similar to Maggie's. It said the endometrium was of normal thickness and suggested fibroid. I then had a CT scan it too did NOT pick up my cancer but referenced fibroid!

After I had some spotting, I had a D&C and found out I had cancer. After my hysterectomy my diagnosis was endometrial cancer, Grade 2/3, Stage 3A. with full myometrial invasion.

So, as a result, I don't have a great deal of confidence in ultrasounds or CT scans....or maybe it was a question of "competence" on the part of the radiologist???


Rewriter's picture
Posts: 497
Joined: Dec 2009

Thanks. I guess the best I can hope for is cautious optimism.


Kaleena's picture
Posts: 2052
Joined: Nov 2009

Hi Jill:

I had transvaginal ultrasound and a laparoscopy. The only thing I was told that I had was endometriosis. However, after my hysterectomy, I had Grade 2 Stage ii/iiia endo cancer. It was in my uterus and on my one ovary. So the ultrasound nor the laprascopy (which they did to look around) didn't pick it up either.

The funny thing is prior to my surgery, I had asked for a CT scan and was told that I didn't need one for endometriosis because it wouldn't show up. But maybe it would have shown the cancer and would have prevented me from having TWO major surgeries instead of one.


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