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Gynecology

Uterine biopsy

01/04/2010

Question:

Hi, I am 45 and had a endometrial biopsy since I have had heavy and prolonged periods of bleeding since last year. I should mention that I never had kids and started my period when I was just 9 years old. So I know I have been exposed to estrogen for a long time.

The doctor`s office called and told me that the biopsy came back with "atypical cells." The office person told me it is not cancer but they do not know why the cells are atypical. I am also scheduled for a pelvic ultrasound. In the meantime, the office person told me the doctor wanted me to start on Provera for ten days.

What are "atypical cells" and why do not not know what they are? Can these atypical cells such as what I described turn into cancer? How does Provera factor into this to help me stop the bleeding?

Thanks for your help.

Answer:

Typically talk about an abnormal endometrial biopsy as simple v. complex and typical or atypical hyperplasia (overgrowth). It is not considered cancer, but rather a precancerous condition. Because the possibility of future cancer can be as high as 30%, the recommendations are typically to proceed with a hysterectomy. The ultrasound will not be able to tell you more about the possibility of cancer. At the least, you could undergo a a surgical procedure to get a visually directed biopsy to rule out cancer (hysteroscopy and dilation & curettage) and if none is found, treat with long-term progesterone (Provera is one type).

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Response by:

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated