Descriptive epidemiology of endometrial hyperplasia in patients with abnormal uterine bleeding.

PURPOSE OF INVESTIGATION: To evaluate the prevalence and epidemiologic characteristics of endometrial hyperplasias in women with abnormal uterine bleeding. METHODS: We performed a retrospective analysis on data gained from 294 patients with histologically documented endometrial hyperplasia (with or without atypia), detected among 1,469 women who underwent fractional dilatation and curettage in our department due to abnormal uterine bleeding from 1986 to 1998. Epidemiologic characteristics were abstracted from the patients' medical charts. RESULTS: 294/1469 women were found with endometrial hyperplasia (258 without atypia and 36 atypical hyperplasias). Thirty-six of them were under 40 years of age. Four of the detected endometrial hyperplasias progressed to endometrial carcinoma (one with simple hyperplasia, two with complex and one with atypical hyperplasia). Obesity and hypertension were justified as risk factors in our study population. CONCLUSIONS: The prevalence of endometrial hyperplasia according to our data was 20%. There were statistically significant differences in most epidemiologic parameters between the two types of hyperplasia. The progression of four endometrial hyperplasias to endometrial adenocarcinoma indicates the need for intense follow-up even in cases where patients undergo conservative therapy.

Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding.

PURPOSE OF INVESTIGATION: To report our evaluation of the prevalence and malignant potentiality of endometrial polyps in women with abnormal uterine bleeding, as well as the efficacy of transvaginal ultrasonography and sonohysterography as diagnostic techniques. METHODS: Fractional dilatation and curettage (D&C) was performed in 1,415 patients aged 23-85 years treated in our clinic for abnormal uterine bleeding from 1986 to 1998. Transvaginal ultrasonography was performed prior to D&C on all patients. Sonohysterography was performed only on 157 patients. Diagnostic efficacy for both techniques was evaluated for the detection of endometrial polyps combined with hyperplasia due to sonographic and histologic difficulties in distinguishing them. RESULTS: The prevalence of endometrial polyps was 8.9% (126/1,415). From all 126 endometrial polyps found, 94 were benign, 30 (23.8%) were found with premalignant changes (complex and atypical hyperplasias) and two (1.5%) had undergone malignant degeneration. Transvaginal ultrasonography was of limited diagnostic value for polyps and hyperplasia in premenopausal women, while in postmenopausal women the method provided a greater yield. Sonohysterography was found to be a more effective diagnostic tool. CONCLUSION: Endometrial polyp prevalence rises by age and/or menopause. Malignant degeneration of endometrial polyps was observed only in postmenopausal women. Sonohysterography represents an improvement over conventional ultrasonography and both methods could be used for screening purposes especially when hysteroscopy can not be performed.

Trends in breast cancer incidence in Thrace, Greece: an epidemiological assessment.

PURPOSE: In the present study we describe the epidemiologic characteristics of breast cancer in relation to certain risk factors affecting the two major ethnic groups (Christian Orthodox and Muslims) in the area of Thrace, Greece. METHOD: We performed a cross-sectional study of 196 consecutive patients, aged 28-85 years, with breast cancer, who were referred to our clinic for treatment from January 1986 to June 1998. All patients were submitted to clinical, laboratory and mammographic control. Ultrasound examination and aspiration cytology were performed on cystic-like lesions. Epidemiologic characteristics of the patients were abstracted from medical charts. To evaluate the results, we used the direct standardization method (1995 Eur. Population) and chi2 test. RESULTS: Breast cancer incidence for the two study populations (Christian Orthodox and Muslims) was 20.9 and 2.3/100,000, respectively. We did not notice statistically significant differences in most epidemiologic characteristics between the two subject groups. CONCLUSIONS: Although the cumulative breast cancer incidence in Thrace, Greece is comparatively low, the discrepancy observed in the incidence of Christian Orthodox and Muslims suggests that differences in lifestyle between these two ethnic groups might be determinant factors influencing the prevalence of the disease. The appearance of the disease in a considerable number of young and elderly women, make the extension of modern screening methods in the above-mentioned age groups necessary for the improvement of breast cancer prevention and incidence rates.

Cytologic diagnosis of axillary lymph node metastasis in breast cancer.

OBJECTIVE: To compare imprint cytology with histology as a method for rapid intraoperative diagnosis of axillary lymph node metastasis in breast cancer. STUDY DESIGN: We evaluated imprint cytology, comparing it with histopathology. A sample of 635 axillary lymph nodes was studied by imprint cytology using both Giemsa stain and hematoxylin-eosin. The results were compared with each other and with those of histopathologic examination. RESULTS: The Giemsa stain method, as compared to histopathology, had 94% accuracy, 97% sensitivity, 90% specificity and 94% positive prognostic value. The hematoxylin-eosin stain method was less accurate than the Giemsa stain method as compared to histopathology (accuracy 91%, sensitivity 96%, specificity 83% and positive prognostic value 92%). CONCLUSION: These data confirm the value of imprint cytology as a rapid, reliable method of intraoperative assessment of axillary lymph node metastasis in breast cancer. It results in better staging of the disease. It can be used intraoperatively, as an alternative to frozen section, if a pathology laboratory is not available, to exclude stage I patients from further treatment.

Epidemiologic aspects of endometrial cancer in Thrace, Greece.

To describe the epidemiologic characteristics of endometrial cancer in relation with certain risk factors affecting the two major ethnic groups (Christian Orthodox and Muslims) in the area of Thrace, Greece. We performed a cross-sectional study of 166 consecutive patients, aged between 29 and 87 years, with documented endometrial cancer who were referred to our clinic for treatment from January 1986 to June 1998. Epidemiologic characteristics of the patients were abstracted from medical charts. To evaluate our results we used the direct standardization method (1995 Eur. Population) and chi2 test. The endometrial cancer incidence for the two study populations (Christian Orthodox and Muslims) was 16.96 and 3.16/100,000, respectively. We observed statistically significant differences in most epidemiologic characteristics between the two major ethnic groups in Thrace (Christian Orthodox and Muslims) regarding endometrial cancer. Our results confirm the increasing trend of endometrial cancer incidence as established in previous investigations.

Biomagnetic measurements in uterine leiomyomas using a superconducting quantum interference device (SQUID).

Using the biomagnetometer superconducting quantum interference device (SQUID), the magnetic signals relating to spontaneous uterine activity were measured for the first time in 25 women with uterine leiomyomas, and 12 women with normal, non-leiomyomatous, uteri. Magnetic radiation, in the range of low frequency (below 2 Hz), was of low amplitudes in normal uterine tissues and of high amplitudes in benign leiomyomas. The observed differences were confirmed by the corresponding power spectra obtained from the statistical Fourier analysis. It is suggested that biomagnetic measurements may facilitate the detection of uterine leiomyomas in equivocal cases.