In 2012, the ACOG Practice Bulletin acknowledged, "the primary role of endometrial sampling in patients with AUB is to determine if carcinoma or pre-malignant lesions are present." (1) The bulletin also states that endometrial biopsy has "high overall accuracy in diagnosing endometrial cancer when an adequate specimen is obtained and when the endometrial process is global." In trying to understand why such biopsies failed in nonglobal pathology, one need look no further than Guido's studies demonstrating that blind biopsy can miss cancers that occupy less than 50% of the surface area.
Routine use of blind biopsy reduces the need for image guided or surgical biopsy as the cost of medical thoracoscopy or image guided biopsy (trained medical staff, nursing assistance, equipment ,operation theatre time and hospital stay) are considerable including the hazards of surgery and general anesthesia.
Traditionally found only by blind biopsy, a procedure that dates from the 1980s, prostate cancer now appears detectable by direct sampling of tumor spots found using Magnetic Resonance Imaging (MRI) in combination with real-time ultrasound, according to the UCLA study