Endometrial Cancer Flashcards
What is the most common type?
What is it’s pre-malignant condition?
→ How is this managed?
When should this straight away be a diagnosis to rule out?
➊ 80% are adenocarcinomas, which are oestrogen-dependent
➋ Endometrial Hyperplasia - most going back to normal over time and <5% going on to become cancer
→ Progestogens e.g. Mirena coil or Oral
➌ In any women presenting with Postmenopausal bleeding!
What are its risk factors?
What are its protective factors?
➊ Exposure to unopposed oestrogen:
• Older age
• Obesity
• Early menarche
• Late menopause
• Nulliparity
• Oestrogen only HRT
• PCOS – The lack of ovulation here means there’s less progesterone production from the corpus luteum
• Tamoxifen – Has an anti-oestrogenic effect on breast, but an oestrogenic effect on endometrium
➋ • COCP
• Mirena coil
• Increased pregnancies
• Smoking – as it’s anti-oestrogenic
How does it present?
What may be found O/E?
➊ • Postmenopausal bleeding
• Intermenstrual bleeding
• Pelvic pain
• Menorrhagia that is unusual for you
➋ Enlarged uterus
Which investigations should be done?
→ Why is a biopsy important to do?
How is it managed?
➊ • TVUS – Look for endometrial thickening
• Pipelle biopsy
→ To differentiate between hyperplasia and ca., and is highly sensitive for endometrial ca., so a -ve result can almost rule it out
➋ • Total hysterectomy w/bilateral salpingo-oopherectomy (TAH + BSO)
• Progesterone can be used to slow progression of the ca.
