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What Is The Chance Of Cancer After Ablation Instead Of Hysterectomy?
Question: Hello. I had an ablation done in 2008 because of extreme thickening of the lining. Biopsy was normal so I chose the ablation. I am post menopausal for >5 years with full blown symptoms of such. I started light spotting last month, had a biopsy with results saying biopsy indicating inactive endometrium - but with the wording "if obtained from endometrium" which it was. The biopsy was preformed twice to gain a large enough sample. Awaiting an ultrasound to be done later this week as I have continued to spot off and on. My question is, since I had the ablation instead of a hysterectomy, if there is even a chance of cancer, is it possible to detect it with ultrasound at this point? Should I be search for another way to find out the cause of this bleeding? Thank you XXXXXXX
Brief Answer:
-transvaginal ultrasound and endometrial sampling.
Detailed Answer:
Hi,
Welcome to healthcare magic.
I am Dr Ramadevi Wani. I will be answering your concerns today.
The postmenopausal spotting that you are experiencing can be due to several reasons. However the reason of at most concern is genital malignancy ( most common is endometrial cancer. Less common are cervical, ovarian, vaginal and vulval cancer) and therefore you need to be evaluated for it. Genital cancer is found in 20% of women presenting with postmenopausal bleeding. This also means that in 80% of women presenting with postmenopausal bleeding the cause is not of serious concern.
One very good news is that the endometrial biopsy report is normal. This almost rules out endometrial cancer. Biopsy is diagnostic.
However since you have persistent spotting it is good to have transvaginal ultrasound. If endometrial thickness is less than 5mm, it suggests that the bleeding in all probability is due to atrophy and not due to cancer. The ultrasound also helps to evaluate for ovarian tumours.
Rarely the scarring due to ablation can delay the early diagnosis of cancer by delaying spotting. But you have already presented with spotting. So I don’t think ablation will come in the way of diagnosis.
I would also recommend that you have a endocervical curettage done for histopathological examination. I presume that you have normal pap smears so far. Vaginal atrophy or vaginal /cervical lesions causing this bleeding can be diagnosed by clinical examination. Since your doctor has not commented about these things you do not have these.
If you continue to have bleeding despite normal endometrial thisckness I recommend that you have hysteroscopic guided biopsy.
The main tools to diagnose endometrial cancer are transvaginal ultrasound and endometrial biopsy ( office biopsy or hysteroscopic guided biopsy).
I hope I have answered your concerns. if you have any other queries do write to me through Healthcare magic.
-transvaginal ultrasound and endometrial sampling.
Detailed Answer:
Hi,
Welcome to healthcare magic.
I am Dr Ramadevi Wani. I will be answering your concerns today.
The postmenopausal spotting that you are experiencing can be due to several reasons. However the reason of at most concern is genital malignancy ( most common is endometrial cancer. Less common are cervical, ovarian, vaginal and vulval cancer) and therefore you need to be evaluated for it. Genital cancer is found in 20% of women presenting with postmenopausal bleeding. This also means that in 80% of women presenting with postmenopausal bleeding the cause is not of serious concern.
One very good news is that the endometrial biopsy report is normal. This almost rules out endometrial cancer. Biopsy is diagnostic.
However since you have persistent spotting it is good to have transvaginal ultrasound. If endometrial thickness is less than 5mm, it suggests that the bleeding in all probability is due to atrophy and not due to cancer. The ultrasound also helps to evaluate for ovarian tumours.
Rarely the scarring due to ablation can delay the early diagnosis of cancer by delaying spotting. But you have already presented with spotting. So I don’t think ablation will come in the way of diagnosis.
I would also recommend that you have a endocervical curettage done for histopathological examination. I presume that you have normal pap smears so far. Vaginal atrophy or vaginal /cervical lesions causing this bleeding can be diagnosed by clinical examination. Since your doctor has not commented about these things you do not have these.
If you continue to have bleeding despite normal endometrial thisckness I recommend that you have hysteroscopic guided biopsy.
The main tools to diagnose endometrial cancer are transvaginal ultrasound and endometrial biopsy ( office biopsy or hysteroscopic guided biopsy).
I hope I have answered your concerns. if you have any other queries do write to me through Healthcare magic.
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. Vinay Bhardwaj
Answered by
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