Transvaginal ultrasound can be used to further evaluate and if a thin echo is seen and bleeding has stopped, no further work-up is necessary
Persistent/recurrent bleeding needs a histologic evaluation even in the presence of a thin echo
Postmenopausal women who are not bleeding
Transvaginal ultrasound should not be used as a screening tool for endometrial cancer in this population
If an endometrial echo >4mm is found incidentally, this is not an automatic ‘trigger’ for further evaluation but rather should be placed in context and “individualized … based on patient characteristics and risk factors”
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