gynae oncology Flashcards
abnormal colposcopy - what to do?
biopsy, or:
LLETZ + smear test of cure at 6mo + then 3yrly (or 5?)
LLETZ - how is it done? efficacy?
loop diathermy
local anaesthetic
90-95% cure
difference between dyskaryosis and CIN
dyskaryosis - how abnormal cells are
CIN - depth of invasion (1/3rds thickness of epithelium) - need biopsy to diagnose
dyskaryosis - prognosis
most returns to normal on its own
may become malignant
CIN - chances of progression to cancer based on level of invasion
1 - 1%
2 - 5%
3 - 12%
cervical cancer - symptoms
post-coital bleeding intermenstrual bleeding postmenopausal bleeding discharge abdo pain
age group for cervical screening
25-65
normal smear doesn’t exclude cancer
what happens if mild dyskaryosis?
test for HPV
positive - refer colposcopy
negative - return to routine 5yrly
HPV test of cure - when done? what should you do if positive? what if negative?
if treated for CIN, test for HPV 6mo after:
-ve - can return to routine call
+ve - colposcopy
endometrial cancer - when it occurs, symptoms + management
75% postmenopausal postmenopausal bleeding (if premenopausal - change in bleeding)
hysterectomy + BSO
if high risk - + radio
RFs for endometrial cancer
tamoxifen + other unopposed oestrogen nulliparity obesity amenorrhoea (↑oest - unshed endomet) early menarche/late menopause PCOS FH diabetes
endometrial cancer - investigations
pregnancy test
FBC - anaemia
tvUSS - thick endometrium (>4mm) + polyps
concerning USS - hysteroscopy + biopsy
post diagnosis endometrial cancer - investigations
MRI pelvis - spread
CT if risk systemic spread
endometrial cancer - management
lap hysterectomy + BSO (as ovaries produce oestrogen which stimulates the cancer)
how frequent is cervical cancer screening?
25-49y - 3-yearly
50-64 - 5-yearly (5 for 50)
