Question of the Week

For March 24, 2020

A 61-year-old postmenopausal woman with a history of obesity reports 2 months of irregular vaginal bleeding. Ten years ago, she was diagnosed with breast cancer and treated successfully with surgery, radiation therapy, and tamoxifen. She has no family history of breast or gynecologic cancer. Physical examination, including a pelvic examination, is normal. Her most recent Pap test, performed one year ago, was normal, with negative testing for human papillomavirus.

What is the most appropriate next step in this patient’s evaluation?

Operative dilatation and curettage of the endometrium
In-office endometrial biopsy
CT of the pelvis
Pap test
Pelvic MRI

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