Gynae Cancers Flashcards
most common type of endometrial carcinoma?
adenocarcinoma
what are the two types of endometrial adenocarcinoma?
endometrioid
serous
what assoc does endometrioid adenocarcinoma have?
oestrogen
lynch syndrome
hyperplasia
what cancers occur in lynch syndrome?
endometrial
colorectal
ovarian
what assoc does serous adenocarcinoma have?
post menopausal
spreads along mucosa/fallopian tubes
aggressive
risk factors for endometrial cancer?
obese nullparity FHx breast cancer oestrogen only HRT tamoxifen
protective factors for endometrial cancer?
CCP
pregnancy
Ix for endometrial cancer?
TVUS
pipelle biopsy
hyteroscopy with D+C
Tx for endometrial cancer?
surgery
radio
chemo
how is lynch syndrome inherited?
aut dom
Ix for lynch syndrome?
MSI test of tissue
stain for mismatch repair proteins
types of ovarian cancer?
serous
mucinous
endometriod
clear cell
what type of ovarian cancer is associated with lynch syndrome?
clear cell
risks for ovarian cancer?
old nullparity FHx breast cancer BRCA
features of ovarian cancer?
asymp bloating ascited mass wt loss fatigue
Ix for ovarian cancer?
serum Ca-125
US
CT
Tx for ovarian cancer?
surgery
chemo
tamoxifen if platinum resistant
spread of ovarian cancer?
transcoelomic
haematogenous
most common type of cervical cancer?
squamous carcinoma
risk factors for cervical cancer?
HPV
multiple sexual partners
immunosuppression
features of cervical cancer?
post coital bleed post menopausal bleed pain haematuria UTI obstruction
Ix for cervical cancer?
exam
colposcopy
biopsy
HPV test
Tx for cervical cancer?
excise
hysterectomy
chemoradiation
who gets endocervical adenocarcinoma?
upper class
late onset sexual activity
smoking
what HPV is assoc with endocervical carcinoma?
HPV 18
what HPV is assoc with cervical cancer?
16 and 18
what is CIN?
premalignant dysplastic transformation of squamous cells in transformation zone of the cervix
in CIN, what happens to the cells?
dysplastic changes to squamous cells on the ectocervix
Ix for CIN?
smear test
colposcopy
tx for CIN?
loop excision
cold coagulation
complications of loop excision?
period abnormalities
pre term labour (due to cervical insufficiency)
in the cervix, what cell types are present in
ectocervix
endocervix?
ecto - squamous
endo - glandular
what is the transformation zone, in the cervix?
squamocolumnar junction between ecto and endo cervix
when is cervical screening started?
25 yrs
how often is cervical screening?
every 3 years from 25-49
every 5 years from 50-64
what is population attributable risk?
what proportion of the disease is caused by the risk factor (measures BURDEN of disease)
what are the 3 types of disease prevention? what do they mean?
primary - stop before it starts
secondary - stop it getting worse/recurring
tertiary - stopping complications
what age of girls get the cervical cancerimmunisation?
11-13yrs
staging for ovarian cancer?
1 - confined to ovary
2 - outside ovary but within pelvis
3 - outside pelvis but within abdo
4 - distant mets
what are the stages for CIN?
1 - one third of surface layer affected
2 - two thirds
3 - full thickness
in CIN, who gets referred?
2 and 3 (within 2 weeks)
features of VIN?
white areas
inflammation
may be warts (due to HPV)
tx for VIN?
biopsy
surveillance
imiquimod cream
if mild dyskariosis on smear, what should be done?
HPV test
if +ve colposcopy
if -ve wait until next smear
if borderline changes on smear, what should be done?
HPV test
if +ve colposcopy
if -ve wait until next smear
tx for CIN 1?
HPV test
if +ve, 6 monthly colposcopy
excision if it does not regress
features of endometrial cancer?
post menopausal bleed
inter menstrual bleeding
wt loss
pain
