Diagnosis of Endometrial Hyperplasia and Cancer

■ Pap smear (to evaluate cervical involvement)

■ Endocervical curettage (specimens from endocervix and cervix must be examined separately to determine if there has been spread)

A positive finding would include endometrial hyperplasia or cancer.

ENDOMETRIAL HYPERPLASIA

In general, the most differentiated hyperplasia is the lowest risk of developing into cancer, and the least differentiated is the highest risk.

Endometrial hyperplasia is a precancerous condition. Types include the following:

Simple (Cystic Hyperplasia Without Atypia)

■ Glandular and stromal proliferation: 1 to 2% progress to cancer (this is the most differentiated and lowest risk of cancer)

Complex (Adenomatous Hyperplasia Without Atypia)

■ Only glandular proliferation (both simple and complex are treated with progesterone)

Atypical

■ Simple type of atypical

■ Complex type of atypical

■ Proliferation with cytologic atypia

Twenty-nine percent of atypical endometrial hyperplasias progress to cancer:

■ Simple type is treated by hysterectomy.

■ Complex type is treated like cancer.

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