Gynecologic malignancies - aa Flashcards
Shockingly, the USPSTF and ACS/ASCCP/ACOG basically agree on cervical cancer screening. What are their recommendations?
~Under 21: don’t screen
~21-29: cytology every 3 years
~30-65: cytology every 3 years or cytology + HPV cotest every 5 years
~65+: if negative cytology for an adequate prior period, can stop screening. Do not restart, even if new sexual partners.
~hysterectomy with cervix removed: don’t screen
~HPV vaccinated: has no effect on screening recommendations
What are the recommendations for endometrial cancer screening?
Don’t do it.
What are the recommendations for ovarian cancer screening?
~USPSTF recommends against screening for ovarian cancer
~ACOG: For women at high risk of epithelial ovarian cancer, such as women with BRCA1/BRCA2, periodic tests to check for ovarian cancer may be recommended. These tests include transvaginal ultrasound and measurement of CA125 levels.
What are the recommendations for vulvar cancer screening?
~ACS: There is no standard screening for this disease other than routine physical examinations.
70% of vaginal cancers and 90% of vulvar cancers are of this type.
squamous cell carcinoma
Vulvar cancer typically appears in what demographic?
postmenopausal women who have had infrequent medical exams
Vulvar cancer just appears out of the blue, unfortunately.
T/F
False.
Long history of vulvar irritation with pruritus, local discomfort, and bloody discharge.
HPV is strongly associated with vulvar cancer in ____ women, whereas in ____ women, vulvar dystrophy and chronic inflammation are the carcinogenic pathways.
younger, older
What is the treatment for vulvar cancer?
excision or vulvectomy
What are the symptoms of vaginal cancer?
~Often asymptomatic
~Postmenopausal vaginal and/or postcoital bleeding are the most common presenting symptoms
If you see signs of vaginal cancer in the vagina, you can diagnose primary vaginal cancer.
T/F
False. Could be primary or metastasis.
~A diagnosis of primary cancer of the vagina cannot be established unless metastasis from another source is eliminated.
What is the treatment for vaginal cancer?
~surgery
~radiotherapy with brachytherapy
What are the most and least common gynecologic cancers?
most common: endometrial
least common: vaginal
What are the presenting s/s of endometrial cancer?
~Abnormal uterine bleeding: menorrhagia, metrorrhagia, or postmenopausal bleeding
What are the risk factors for endometrial cancer?
~Risk factors: hyperestrogenism—long-term exposure to unopposed estrogens (PCOS, chronic anovulation, late menopause, exogenous estrogens); metabolic syndrome including diabetes, hypertension, and obesity; nulliparity; increasing age; history of breast cancer; genetic predisposition
How is endometrial cancer diagnosed?
endometrial sampling, ultrasonography
How is endometrial cancer treated?
The mainstay of treatment is surgery, including a total hysterectomy with bilateral salpingo-oophorectomy and staging with pelvic and periaortic lymphadenectomy.
Unlike cervical cancer, endometrial carcinoma is not related to sexual history.
T/F
True
What is the most common gestational trophoblastic disease? Is it benign or malignant?
Hydatidiform mole is the most common form of gestational trophoblastic disease and is benign in nature.
In what demographics is hydatidiform mole more common?
~under 20 and over 40
~nulliparous
~lower socioeconomic status
~diet deficient in protein, folic acid, and carotene
What unique and characteristic tumor marker is associated with gestational trophoblastic tumors?
hCG
From what is hydatidiform mole thought to arise?
extraembryonic trophoblasts
Choriocarcinoma may accompany or follow any type of pregnancy.
T/F
True
50% of choriocarcinomas are preceded by hydatidiform mole.
T/F
True
