Endometrial cancer Flashcards
Two major type of endometrial cancer
- Type 1 - Endometroid adenocarcinoma
2. Type 2 - Serous papillary carcinoma
What is type 1 endometrial cancer called?
Endometrioid adenocarcinoma
Frequency of type 1 endometrial cancer?
Accounts for 90% of endometrial adenocarcinomas
What demographic is type 1 endometrial cancer common in?
Younger women
Which endometrial cancer is oestrogen dependant?
Type 1 - Endometrioid adenocarcinoma
Type 2 is oestrogen independant
Prognosis of type 1 endometrial cancer
GOOD
What demographic is type 2 endometrial cancer common in?
Elderly dependant
Prognosis of type 2 endometrial cancer?
Poor prognosis
Mean age of endometrial cancer diagnosis?
54
Genetic cause of endometrial cancer
HNPCC gene
Etiology of endometrial cancer
High circulating levels of oestrogen.
Risk factor of endometrial cancer
- Obesity
- Nulliparity
- Late menopause
- Tamoxifen therapy for breast cancer
- HRT/oestrogen therapy
- PCOS
How can we reduce the risk of endometrial cancer?
Use of oral contraceptive pill can reduce incidence of endometrial cancer by up to 50%
Clinical features of endometrial cancer
- Abnormal bleeding
- post menopausal bleeding
- irregular vaginal bleeding
- intermenstrual bleeding
- heavy bleeding
Major symptoms of endometrial cancer
POSTMENOPAUSAL BLEEDING
Ix for endometrial cancer
- Speculum
- Bimanual exam
- Transvaginal ultra sound
- Endometrial biopsy
Transvaginal ultrasound - results
- Allows for a quick and accurate assessment of endometrial thickness
- < 4 mm thickness : cancer is very unlikely
> 4 mm thickness on TVS leads onto;
- Hysteroscopy to visualise the whole endometrium
2. Direct biopsy to be performed to confirm endometrial cancer diagnosis
Who should be fast tracked on suspected cancer pathway?
women >= 55 years who present with postmenopausal bleeding should be referred using the suspected cancer pathway
Mx of Endometrial cancer
- Localised disease is treated with total abdominal hysterectomy with bilateral salpingo-oophorectomy.
- Patients with high-risk disease may have post-operative radiotherapy
