If At First You Don'T Succeed: Follow-Up Care Trajectories For Women With Failed Endometrial Biopsies

Introduction: Office-based endometrial biopsy (Pipelle) is an important minimally invasive diagnostic modality for endometrial cancer and benign gynecologic disease but does have a substantial failure rate. Little is known about trajectories of care following failure of Pipelle procedures, as studies in this area have been almost exclusively based on review of medical records, which may not include information on failures due to inability to obtain samples to send to pathology. Methods: Women undergoing a Pipelle biopsy in a tertiary women9s care center (n= 121) were recruited from August 2017 to June 2019 with post-menopausal and abnormal bleeding as a biopsy indication in the majority of cases. Patients9 relevant demographic and clinical data were extracted from their medical records and from surveys administered to providers immediately after attempted procedures. Overall failure of their Pipelle biopsy was defined by either a failure to obtain a sample at all (sampling failure) or a failure due to having a sample with insufficient tissue for histopathological diagnosis (tissue failure). Participants9 medical records are currently being abstracted for a period of one year after the date of the Pipelle procedure to prospectively track their follow-up care trajectories. Descriptive statistics and tests of dichotomous relationships were performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA). Results: The study sample included 35 women (29% of the original cohort) for whom there was an overall failure of Pipelle biopsy (mean age=56, SD=8; mean BMI=33, SD=10). Among women with overall biopsy failures, 63% were due to sampling failures (attributed by providers to stenotic cervix, body habitus, and procedure intolerance), while 37% were due to having insufficient tissue acquired for pathological diagnosis. Follow-up procedures and/or counseling have already been conducted in the majority of patients and found to include: hysteroscopy/DC 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2303.