Histopathological Evaluation of Endometrial Biopsies in Different Age Groups: A Tertiary Care Experience in Turkey

Background: An endometrial biopsy primarily aims to determine endometrial cancer and hyperplasia with atypia at an early stage. Objectives: This study aims to evaluate the indications, histopathological diagnoses, and the number of endometrial biopsies performed in our clinic, according to the age groups of patients, in light of the literature. Methods: A retrospective review was conducted on the file data of 4,965 patients who underwent endometrial biopsy for non-obstetric reasons between 2014-2021. The patients were divided into five groups, according to their age. Pathology diagnoses were classified as benign endometrial pathology, premalignant-malignant pathology, and insufficient for diagnosis. Results: The most common biopsy indication was abnormal uterine bleeding (61.9%), while the most common histopathological result was benign endometrial pathologies (75.3%). Endometrial cancer was also detected in 3% of the patients. The highest diagnosis of benign endometrial pathology among age groups was 96.6% in those below 35. The comparison of age groups in the diagnosis of premalignant-malignant pathology revealed that the highest diagnosis rate was 32.1% in those 65 years and over. Furthermore, the evaluation of the relationship between indications and material adequacy showed that the highest rate of insufficient for diagnosis pathology was in the postmenopausal patient group (34.0%). Moreover, insufficient for diagnosis and endometrial surface epithelium results were highest in patients over 65 (46.7%). Conclusion: Patients aged 55-64 and those over 65 had the highest rate of endometrial cancer and insufficient for diagnosis biopsy results. Therefore, dilation and curettage may be recommended while taking a biopsy from patients in this age group.