Design: Retrospective cohort study.

Setting: Single tertiary, university affiliated, medical center.

Patients or Participants: We reviewed all patients who underwent surgical staging for preliminary diagnosis of uterine malignancy at a single institution between 2016-2022, and had tissue diagnosis obtained prior to surgery.

Interventions: none.

Measurements and Main Results:

Out of the 305 cases which were reviewed, 216 had primary endometrial malignancy. Out of this cohort,60 patients were surgically diagnosed with Non-endometroid malignancy(27%). Tissue was obtained for 67 through hysteroscopy(31%), 97 with a Pipelle(45%) and 52 underwent a D&C(24%).

The sensitivity and specificity of hysteroscopy for Non-Endometroid uterine malignancy, were 80%, and 90.4% respectively, Pipelle were 74.2% and 95.5%, respectively, and D&C were 83.3% and 99% respectively.

Surgical pathology resulted in histological “upgrading” from Endometroid carcinoma to Non-endometroid carcinoma in 12% of the hysteroscopies, 16.5% of the Pipelles and 14.3% of the curettages, there was no statistically significant difference between the groups(p=0.46).

Conclusion: The detection rate for Non-endometroid uterine malignancy appears to be equal for all common endometrial biopsy techniques. Further studies are required to confirm this finding.