Factors influencing the detection of uterine cancer by suction curettage and endometrial brushing

OBJECTIVE: To analyze the factors that influence the detection of uterine cancers by Pipelle(R) and Tao. Brush(TM) endometrial sampling devices. STUDY DESIGN. Seventy-nine Pipelle(R) currettages were followed by Tao Brush(TM) sampling. The curettage specimens were fixed in formalin for histology and reported by surgical pathology, whereas the Tao Brush(TM) specimens were fixed in CytoRich Red(R) for histology and cytology and reported by cytopathology. Uterine size and features of residual tumors were obtained from hysterectomy reports. Follow-up for clinically benign cases ranged from 16 to 52 months (mean, 33.7; median, 34). RESULTS: There were 10 uterine cancers and 9 hysterectomies. Five cases of centrally located adenocarcinoma, ranging from 0.4 to 3 cm, were detected by both samplers. Additionally, a Tao Brush(TM) sampled an adenocarcinoma located near the cornu. An endometrial stromal sarcoma found with a Tao Brush(TM) was reported as necrotic tissue by Pipelle(R). Both samplers missed a microscopic focus of adenocarcinoma, an in situ adenocarcinoma in a polyp and a large leiomyosarcoma. CONCLUSION: The size and type of tumor and its location within the uterine cavity, the mechanism of sampling and preparation method influence the detection of uterine cancer by the Pipelle(R) and Tao Brush(TM).