Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
19 Cards in this Set
- Front
- Back
|
a) True or False: Epithelial ovarian cancer (EOC) is the leading cause of gynecologic cancer death in North America
b) What is the lifetime baseline risk of contracting EOC? |
a) True
b) 1.5% |
|
|
a) What percentage of ovarian cancer is EOC?
b) How many have Stage >= II disease? c) What is the average decade of diagnosis? |
a) 85-90%
b) 75% c) 60's |
|
|
a) List histologic types of EOC?
b) What is the most common? |
Serous (most common)
Mucinous Clear cell Endometrioid Brenner Neuroendocrine Sarcomatous |
|
|
List risk factors for EOC.
|
Estrogen
Nulliparity Early menarche Late menopause Infertility Age Hereditary syndrome BRCAI (40%) BRCAII (15-20%) Lynch II (10%) Geographic location (North America) Ethnicity (northern european, jew, icelandic, hungarian) Drugs Menopause HT (estrogen) Family history of ovarian cancer (RR 3.0) PCOS Endometriosis |
|
|
List protective factors against EOC
|
OCP use (RR 0.5)
Breast feeding BSO Tubal ligation |
|
|
a) Should CA125 be used to screen average-risk populations?
b) What percentage of women in the background population with no/benign disease have an elevated CA125? |
a) No.
b) 1% |
|
|
a) What other processes can cause an increase in CA125 level?
b) What is CA125? |
a)
Endometriosis Menstruation PID Fibroids Liver disease b) MUC16 gene product, binds mesothelin |
|
|
a) What percentage of women with early stage EOC have an elevated CA125?
b) Late stage EOC? |
a) 50%
b) 80% |
|
|
In asymptomatic post-menopausal women, does an elevated CA125 (>30U/ml) increase the risk of EOC?
|
Yes.
If CA125 > 30U/ml, RR 35 for EOC w/i one year If CA125 > 100U/ml, RR 200 for EOC w/i one year |
|
|
What percentage of women with invasive ovarian cancer will be BRCA I or II positive?
|
13%
|
|
|
a) What is the recommended screening strategy for ovarian cancer in women at average risk?
b) What is recommended for women on a yearly basis? |
a) None. Nothing has been shown to be effective. No North American expert groups recommend screening.
b) Pelvic exam |
|
|
a) What women are at highest risk of developing ovarian cancer?
b) Discuss screening of these women. |
a)
BRCA I BRCA II Lynch II b) Controversial. Consider risk reduction surgery. Consider OCP. Consider q6-12m CA125 and TVUS. No screening program has been shown to be effective. |
|
|
List the most common symptoms associated with EOC
|
Pelvic/Abdominal pain
Urinary frequency/urgency Early satiety Bloating/increased pant size |
|
|
What is Meigs' syndrome?
|
Pelvic Mass (benign ovarian fibroma)
Ascites Pleural effusion |
|
|
a) Histologically, what distinguishes borderline ovarian tumours (LMP) from ovarian cancer?
b) Histologically, what distinguishes borderline tumours from benign ovarian cysts? |
a) no stromal invasion
(10% may have areas of microinvasion <3mm, covering <5% of tumour) b) atypia cellular pleomorphism mitotic activity microscopic papilla stratified epithelium |
|
|
List 5 features of physical exam or imaging that might help distinguish a borderline ovarian tumour from EOC?
|
Fixed ovarian mass (exam)
Ascites (CT/US) Omental caking (CT) Mets (CT) Nodal status (PET) |
|
|
After fertility-sparing surgery, what is the risk of recurrence of ovarian LMP in the contralateral ovary?
|
15%
|
|
|
What is the 5 yr survival for ovarian LMP at stage:
I II III IV |
a) 99%
b) 98% c) 96% d) 80% |
|
|
How are patients with ovarian LMP staged?
|
Same as for EOC.
|
