Résumé
Objectif
Issues
Résultats
Valeurs
Avantages, désavantages et coûts
Recommandations
- 1.L'échographie transvaginale ne devrait pas être utilisée aux fins du dépistage du cancer de l'endomètre (II-1E).
- 2.Chez les femmes postménopausées qui ne présentent pas de saignements, le prélèvement endométrial ne devrait pas être mis en œuvre de façon systématique (II-1E).
- 3.Les indications menant au prélèvement de tissu endométrial chez les femmes postménopausées présentant des saignements et une épaisseur endométriale supérieure à 4–5 mm ne devraient pas être extrapolées aux femmes asymptomatiques (II-2E).
- 4.Les femmes qui présentent un épaississement endométrial au moment de l'échographie et d'autres résultats positifs (vascularité accrue, inhomogénéité de l'endomètre, liquide particulaire, endomètre excessivement épaissi [ > 11 mm]) devraient être orientées vers des gynécologues aux fins de la tenue d'explorations plus approfondies (II-1A).
- 5.Chez les femmes qui présentent un épaississement endométrial accru et des facteurs de risque de cancer de l'endomètre (tels que l'obésité, l'hypertension et la ménopause tardive), les décisions quant à la tenue d'explorations plus approfondies devraient être prises au cas par cas (II-1B).
- 6.Chez les femmes asymptomatiques qui prennent du tamoxifène, une échographie visant à déterminer l'épaississement endométrial ne devrait pas être mise en œuvre de façon systématique (II-2E).
- 7.Le recours à la chirurgie ne s'avère pas nécessaire chez toutes les femmes postménopausées qui présentent des polypes endométriaux asymptomatiques. Les femmes chez lesquelles des polypes asymptomatiques sont découverts au moment de l'échographie devraient faire l'objet d'un triage (en vue d'une intervention) en fonction de la taille des polypes, de l'âge et d'autres facteurs de risque (II-1A).
Mots clés
Abréviations:
ÉTV (Échographie transvaginale), HT (Hormonothérapie)Purchase one-time access:
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- No. 249-Asymptomatic Endometrial ThickeningJournal of Obstetrics and Gynaecology Canada Vol. 40Issue 5