endometrial cancer Flashcards
in whom is endometrial CA classically seen in?
post-menopausal women
but ~25% occur before menopause
what is the Px of endometrial CA?
good, due to early detection
what are the risk factors for endometrial CA?
- unopposed oestrogen ⇒ addition of progestogen reduces risk (in HRT)
- DM
- tamoxifen
- PCOS
- HNPCC
- obesity
- nulliparity
- early menarche
- late menopause
what are the features of endometrial CA?
- post-menopausal bleeding (classic sx)
- pre-menopausal women may have a change intermenstrual bleeding
- unusual: pain and discharge
what should you do for women ≥55 years presenting with post-menopausal bleeding?
refer using suspected cancer pathway
what is the 1st line Ix for endometrial CA?
trans-vaginal ultrasound
a normal endometrial thickness (<4mm) has a high -ve predictive value
what should be done for a woman with persistent intermenstrual bleeding / woman ≥45 years old with failure/ineffective treatment?
hysteroscopy with endometrial biopsy
to exclude endometrial CA / atypical hyperplasia
how is endometrial CA with localised disease managed?
total abdominal hysterectomy with bilateral salpingo-oophorectomy
how are high-risk pts with endometrial CA treated?
total abdominal hysterectomy with bilateral salpingo-oophorectomy
(+) post-op radiotherapy
what is sometimes used in frail elderly women not suitable for surgery?
progestogen therapy
what are protective factors for endometrial CA?
- COCP
- smoking
in a female with PMB (post menopausal bleeding), what is the dx unless proven otherwise?
endometrial adenocarcinoma
