Endometrial Cancer

Question 1

what is the penny, nicket, dime, quarter?

Answer 1

simple hyperplasia w/o atypia = 1% progression to cancer

complex hyperplasia w/o atypia = 3-5%

simple hyperplasia w/ atypia = 8-10%

complex hyperplasia w/ atypia = 25-30%

Question 2

what are risk factors to developing endometrial hyperplasia

Answer 2

increased E levels

tamoxofen, obese, PCOS/anovulation, nulliparity, early menarche and late menopause, granulosa cell tumors

Question 3

What are protective factors to developing endometrial hyperplasia

Answer 3

decreased E elevels/inc P levels

OCPs, multiparity, diet and exercise

Question 4

HNPCC/Lynch syndrome is high risk for what cancers

Answer 4

colon
endometrial
ovarian

**get annual endo bc > 35 yo

Question 5

what are the 2 types of endometrial cancers

%
race
Age
Pa

Answer 5

type I: E dept | 80% | white | perimenopausal | good px
**preceeded by hyperplasia

type II: E indept (papillary serous or clear cell) | 20% | black, asian | postmenopausal | bad

Question 6

Smx of endometrial cancer

Answer 6

postmenopausal or abnormal vaginal bleeding

Question 7

Management for abnormal bleeding suggestive of endometrial cancer

Answer 7

premenopausal = endometrial bc then proper tx

postmenopausal = US, if endometrial strip > 5mm get endometrial bx (if < 5mm, no further workup)

Question 8

differentiates stage I from II endometrial CA

II from III

Answer 8

II invades endocervix

III in nearby structures (serosa, vagina, pelvic LN)

Question 9

treatment for endometrial CA

Answer 9

TAHBSO
pelvic/paraaortic LNectomy
radiation (if high risk)

Question 10

Stage or grade more important for prognosis

Answer 10

grade

Question 11

what is the diff between G1, G2, and G3

Answer 11

G1 = 50% ‘’

Question 12

what are characteristics for high risk endocervical cancers

Answer 12

• > 50% myometrial invasion
• type 2 (papillary, serous, clear cell)
• grade 3
• stage III+
• size > 2cm
• LN+