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Should Hysterectomy Be Undergone When Suffering From Pre-cancerous Polyp?

Posted on Tue, 19 May 2015

Question: I had breast cancer in 2001 at the age of 37, followed by mastectomy, chemo, radiation, and tamoxifen for 5 years. I was estrogen receptive and had 4 nodes that were positive. I just had my first colonoscopy and had a polyp that was pre-cancerous and now am having surgery to remove it. My question is should I have a hysterectomy at the same time? I have not done genetic testing.

Answered by Dr. Aarti Abraham (1 hour later)

Brief Answer:
The biopsy report is critical to determining whether hysterectomy is needed

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Could you let me have more details regarding the polyp please ?
There are various kinds, and all of them have distinct risks of developing into endometrial carcinoma later on.
Could you upload the histopathology report ?
Also, do you have any family history of breast / uterine cancers / colon cancers ?
There is a definite genetic corelation between colon cancers and uterine cancers, but the relationship between prior breast cancer and subsequent uterine cancer is not yet strongly established.
People with a history of breast cancer may also be at increased risk for endometrial cancer, but this is difficult to determine as many of the risk factors for breast and endometrial cancer overlap. As of yet, there has not been any association found between genes associated with breast cancer, such as the BRCA1 gene, and endometrial cancer, though studies are ongoing.
If you do not have am ominous family history, then I do not think you should go in for a formal hysterectomy.
However, I would like to look at the biopsy report of the polyp first.
Then I could comment in a better fashion.
All the best
Please feel free to discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (6 minutes later)

Yes I can upload the biopsy report tomorrow. My paternal grandmother had breast cancer and my maternal grandfather had colon cancer.

Answered by Dr. Aarti Abraham (23 minutes later)

Brief Answer:
Better to get the genetic testing first.

Detailed Answer:
Okay, so you have a high familial risk of cancers.
It makes sense to go for the genetic testing first.
IF that comes out positive, you can opt for a formal hysterectomy.
Can you get the genetic testing done first ?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (12 hours later)

yes, waiting on approval from insurance so won't have that done until mid- next week. I will upload polyp report now. I could postpone surgery until the 20th and then I would have more time to get results from genetic testing and not feel so rushed making this decision. My other option is to have just the colon surgery now and postpone hysterectomy until the fall.

Answered by Dr. Aarti Abraham (2 minutes later)

Brief Answer:
I think it is better to wait for the gentic testing.

Detailed Answer:
Yes, please upload the polyp report, as of now I cannot see it.
And yes, do not rush into any surgery until the genetic testing comes in.
Better to postpone the surgery until the 20th, as you will then go in with more information and understanding.
There is no medical emergency here.
I am not much for the other option of having just the polyp removal now, and then taking a call on the hysterectomy later on.
Better subject yourself to surgical risks and anesthetic risks only once.
Waiting for the reports to be uploaded.
Take care.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Aarti Abraham (56 minutes later)

here is the biopsy report: review of the cecal poly[s contain multiple fragments of tubulovillous adenoma.
I just read this off of the anatomic pathology report i have a copy of. Hope this is what you need.

Answered by Dr. Aarti Abraham (30 minutes later)

Brief Answer:
Can you upload it please ?

Detailed Answer:
I would actually prefer it if you could upload it, please.
And what symptoms did you have , how was this diagnosed ?

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Aarti Abraham (41 minutes later)

It was a routine colonoscopy. The first one I ever had. I had no symptoms.

Answered by Dr. Aarti Abraham (2 minutes later)

Brief Answer:
Kindly upload the report.

Detailed Answer:
Okay, then can you upload the exact report, scan and upload it please ?

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Aarti Abraham (41 minutes later)

I uploaded the report for XXXXXXX This is XXXXXXX her husband. I hope this will work for you. Thank you.
XXXXXXX

This is XXXXXXX did you get the path report my husband sent you?

Answered by Dr. Aarti Abraham (9 hours later)

Brief Answer:
Need the colonoscopy report too.

Detailed Answer:
Okay, I got the path report.
Could you please upload the actual colonoscopy report also ?
Also, what procedure has been planned for the polyps ?

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Aarti Abraham (12 hours later)

A colorectal surgeon is going to remove the polyp and part of the colon surrounding it. He is planning on doing laparoscopic surgery. He doesn't think its cancer. I am unsure how to upload colonoscopy report but I know there was stool found in parts of my colon so the surgeon is wanting me to have another one next week. I am waiting for my husband to tell me how to send you the report.

Answered by Dr. Aarti Abraham (39 minutes later)

Brief Answer:
Will wait for the colonoscopy report.

Detailed Answer:
OKay,
I will wait for the colonoscopy report.
I would want to comment only after that.
ANyways, have you decided to postpone the surgery until you receive the genetic tests ?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (14 minutes later)

thank you for being patient

not sure, want this taken out asap. Definitely not on the 12th, would like the surgery May 20 if genetic testing is back. When I asked the surgeons nurse about having a hysterectomy during the same surgery she asked the surgeon and he said not to have anything else done unless I was having problems. So I didn't really like the answer to that; I'm trying to avoid a possible recurrence in the future.

After you read colonoscopy report please let me know if this surgery still isn't a medical emergency. Thanks

Answered by Dr. Aarti Abraham (11 hours later)

Brief Answer:
THis is not a medical emergency in the least.

Detailed Answer:
Hello
Thank you for uploading all the reports in detail.
First of all, this is NOT a medical emergency at all.
You can easily wait for your genetic test report, so that you can make an informed decision.
There is a polypoid mass, and it is pre cancerous, but nothing is going to flare up in 2 weeks time.
You cannot decide for or against a hysterectomy till you know your risk of having a genital tract malignancy, which only the genetic testing will tell you.
SO it makes all the sense in the world to wait for it, else you will have to go by your instinct.

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar