Endometrial sampling is usually recommended to rule out hyperplasia or cancer in women with any of the following: Age ≥ 45 years Age < 45 years with one or more risk factors for endometrial cancer (see above) Abnormal bleeding that is persistent or recurs after a normal initial evaluation and despite treatment Postmenopausal patients with abnormal endometrial findings detected during transvaginal ultrasonography (endometrial thickness > 4 to 5 mm or with focal or irregular endometrial thickening) Inconclusive ultrasonography findings in a patient with suspected endometrial neoplasia In endometrial sampling (which may be done as an office endometrial biopsy or a dilation and curettage procedure), only about 25% of the endometrium is analyzed, but sensitivity for detecting abnormal cells is approximately 97%.