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Endometrial cancer investigation — MCCQE Part 1 MCQ

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EasyPost-menopausal BleedingEndometrial cancer investigationMCCQE Part 1

A 50-year-old postmenopausal woman has a single episode of vaginal bleeding. Not on HRT. BMI 38. TVU: endometrial thickness 8mm. Most appropriate next step?

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Correct answer: A — Endometrial biopsy (Pipelle)

Any postmenopausal bleeding with endometrial thickness >4-5mm: endometrial sampling mandatory. Obesity (BMI 38) is significant risk factor for endometrial cancer. Do not start HRT before excluding malignancy.

Reference: SOGC Endometrial Cancer Screening