Endometrial biopsy and curettage sample only part of a tumour, and the most aggressive component often lies at the invasive front, which a pre-operative sample cannot reach. Grade, histological type and unusual components can all change between biopsy and hysterectomy.
The pre-operative report guides surgical planning, so it helps to say what was and was not sampled, and to flag uncertainty. Review of the biopsy alongside the resection, and reporting any change, keeps the oncologist's decision on the more complete picture.
- State in the biopsy report when sampling is limited or the grade is uncertain.
- Review the pre-operative material alongside the hysterectomy specimen.
- Report any change in type or grade between biopsy and resection explicitly.
- Make sure the molecular classification uses the most representative material.
Why it matters
Surgical staging and adjuvant decisions can hinge on a grade that the biopsy may have understated.
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