Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RGU 2 > Endometrial Cancer > Flashcards

Endometrial Cancer Flashcards

1
Q

How do cancers spread?

A
  • LOCAL EXTENSION= grow into adjacent structures (bladder, rectum, peritoneal cavity).
  • LYMPHATIC (pelvic, para-aortic, groin lymph nodes).
  • HEMATOLOGIC= travel through blood to distant sites (lungs, brain, bone).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the number 1 risk factor for endometrial cancer?

A

obestity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should you be sure to do when performing a physical exam for possible endometrial cancer?

A
  • speculum exam= look for normal vagina, normal cervix, no lesions.
  • pelvic exam= cannot appreciate uterine size or adnexa.
  • recto-vaginal exam= feel for normal sphincter tone, no blood, no mass, no nodularity.
  • endometrial biopsy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What imaging modality would be helpful for a suspected endometrial cancer?

A
  • pelvic ultrasound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Can you do an endometrial biopsy in the office w/o anesthesia?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What if your patient can’t tolerate the biopsy?

A

D&C +/- hysteroscopy (camera in the uterus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is post-menopausal bleeding cancer until proven otherwise?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What would a SEROUS endometrial carcinoma (type II) look like?

A
  • papillary (finger-like) projections

* actually more common in the ovary, but when in the uterus, these are more aggressive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What 2 genetic mutations put a woman at increased risk for endometrial cancer?

A
  1. Lynch syndrome (mismatch repair genes)

2. Cowden syndrome (PTEN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In what age group does endometrial cancer occur most?

A
  • POSTmenopausal age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

*** What are the 2 types of endometrial cancer?

A
  1. HYPERPLASIA (type I)= unopposed estrogen leading to endoMETRIOID histology because it looks a lot like the endometrium (age 50-60).
  2. SPORADIC (type II)= ATROPHIC endometrium (no evident precursor lesion and) driven by p53 MUTATION leading to SEROUS histology characterized by PAPILLARY structures (age greater than 70). Think “S” for Sporadic and Serous.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

** Does type I or type II endometrial cancer have a better prognosis?

A
  • TYPE I
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

** With what is type I (hyperplasia) endometrial cancer related?

A
  • related to OBESITY/metabolic syndrome, and tamoxifen (SERM) use.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

** With what is type II (sporadic) endometrial cancer related?

A
  • African Americans, HNPCC, and majority have metastasis.

* remember Serous or clear cell types.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some protective factors of type I (hyperplasia) endometrial cancer?

A
  • smoking

- oral contraceptive use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Are most endometrial cancers type I or type II?

A
  • type I (90%)
17
Q

What is the 5 year survival for a pt with type I endometrial carcinoma?

A
  • confined to uterus= 95%
  • lymph node mets= 67%
  • distant mets= 16%
18
Q

** How are uterine cancers staged? (TEST QUESTION)

A
  • SURGICALLY only.

* different from cervical cancer which is done via radiological studies or exam.

19
Q

What does total hysterectomy mean?

A
  • removal of only cervix and uterus.
20
Q

What procedure removes the fallopian tubes and ovaries?

A
  • bilateral salpingo-oophorectomy (BSO)
21
Q

From what artery does blood supply come to the uterus?

A
  • internal iliac artery
22
Q

What are the stages of uterine cancer (FIGO staging)?

A
  • Stage 1= confined to uterus
  • Stage 2= spread to cervix and stroma
  • Stage 3= spread to nodes
  • Stage 4= distant mets
23
Q

What adjuvant treatments are used for endometrial cancer after surgery, based on stage?

A
  • stage 1= nothing
  • stage 2= radiation
  • stage 3= chemo + radiation
  • stage 4= chemo
24
Q

What should you tell a patient who has type 1 (endometrioid) low grade uterine cancer?

A

they will have a good prognosis and if the cancer returns after treatment (which is unlikely), radiation will likely salvage and she’ll be ok.

25
Q

From where do uterine SARCOMAS (leiomyosarcoma) come?

A

myometrial layer

26
Q

*** Are leiomyomas (fibroids) common in women?

A
  • YES
27
Q

** Are leiomyosarcomas common in women?

A

NO!!

28
Q

** Is rapid uterine enlargement a specific symptom of uterine sarcoma (leiomyosarcoma)?

A

NO

29
Q

Should you use power morcellators (device used to cut up large chunks of tissue into smaller pieces) to remove a uterine sarcoma (leiomyosarcoma)?

A

FDA says no.

- you should completely resect the malignancy.

30
Q

What is the prognosis for leiomyosarcoma?

A
  • not very good (stage 1= 66%).
  • adjuvant treatment (radiation or chemo after surgery) is NOT proven to reduce risk of recurrence.
  • oophorectomy does not impact prognosis.
31
Q

** What is the most common GYN cancer?

A

endometrial cancer

32
Q

** Does all post menopausal bleeding require evaluation?

A

YES

RGU 2 (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions