CÁNCER DE OVARIO: TIPOS, FACTORES de RIESGO, SÍNTOMAS, DIAGNÓSTICO... - Ginecología y Obstetricia -

OVARIAN CANCER Dr. Melgar discusses ovarian cancer: Epidemiology, risk factors, and diagnosis. More videos, podcasts, PDFs, and more... AULAGINECOLOGIA.COM (Follow us on Facebook, Twitter, and Instagram @aulaginecologia) EPIDEMIOLOGY Ovarian carcinoma is the second most common gynecological malignancy in developed countries (after endometrial cancer) and the third most common in developing countries (where cervical cancer predominates). RISK FACTORS Advanced age, especially after 50, with a maximum age of 55 to 65. Early menarche or late menopause. Each ovulation causes minor damage to the ovary, which, when repeated, could lead to malignant transformation. Genetics. Genetic mutations associated with hereditary syndromes such as BRCA1, BRCA2, or Lynch syndrome (hereditary nonpolyposis colorectal cancer). It is believed that up to 25% of ovarian tumors originate from a genetic mutation. Nulliparity. Endometriosis: the overall risk of developing ovarian cancer is low. If ovarian cancer is present, it is more frequently associated with endometrioid and clear cell types. Asbestos exposure has been associated with a higher risk of death from this cancer. History of prior pelvic radiation, for example, after rectal cancer. PROTECTIVE FACTORS Patients exposed to periods of anovulation, such as those using oral contraceptives (reduction of more than 50% in risk when used for 10 years or more), multiple pregnancies (reduces the risk by 8% for each pregnancy), or breastfeeding (reduction of 30%, especially if it lasts more than 12 months). Surgical treatments include: hysterectomy (20% reduction), bilateral salpingo-oophorectomy, and tubal ligation (20% reduction). *The fallopian tubes must be removed, as tubal neoplasia plays an important role in the pathogenesis of epithelial ovarian cancer. SCREENING In the general population, there is no evidence to support an effective screening program for ovarian cancer. There is no effective screening strategy that reduces mortality, and those that have been proposed are associated with a high probability of false positives, with a risk of harm to the patient. HISTOPATHOLOGY AND PATHOGENESIS 95% of malignant ovarian neoplasms derive from epithelial cells (subtypes include high-grade and low-grade serous, endometrioid, clear cell, and mucinous), and the remainder arise from other cell types (germ cell tumors, sex cord-stromal tumors). Serous carcinoma is the most frequent subtype: 75% of all epithelial tumors. CLINICAL PRESENTATIONS Most patients present with Stage III (extended into the peritoneal cavity and/or lymph node involvement) at the time of diagnosis. DIAGNOSTIC PROCESS When we encounter a patient with findings suggestive of ovarian cancer, the diagnostic sequence is usually: 1. INITIAL EVALUATION: aims to determine the degree of clinical suspicion of malignancy. 2. ADDITIONAL TESTS To rule out metastatic disease and plan the appropriate medical and surgical treatment. 3. SURGICAL EXPLORATION Laparoscopy: assesses pelvic and abdominal extent. It allows exploration of the cavity, taking biopsies or cytology samples from any suspicious lesions, and evaluating the cavity before considering possible cytoreductive surgery. It also allows for disease staging. Other topics: Bleeding after menopause:    • SANGRADO POSTMENOPÁUSICO: Causas, evaluaci...   Uterine polyps: https://www.youtube.com/watch?v=THQUI... Uterine fibroids: https://www.youtube.com/watch?v=zHoXC... Heavy menstrual bleeding: https://www.youtube.com/watch?v=V854E... Other videos, podcasts, PDFs, and much more: AULAGINECOLOGIA.COM