Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
01701
Tel: (781) 890-9095
Endometrial Cancer
Endometrial cancer or cancer of the uterine corpus is a neoplasm affecting
the inside lining of the uterus (endometrium). It is the most frequent occurring
genital cancer in women. In the United States, while it’s occurrence is
approximately 4 times greater than cervical cancer, less than 20% of women
will die from the disease. Mortality is significantly greater in African-American
women. Genetic predisposition is supported by an increased risk of
developing endometrial cancer in patients with a positive family history of the
disease. Women who themselves had breast or ovarian cancer are also at a
greater risk of developing endometrial cancer.

About 75% of endometrial cancers will first appear after menopause. In
postmenopausal women, the most common presenting symptom is
postmenopausal vaginal bleeding. The most common symptom in the 25% of
women who will develop endometrial cancer before they reach menopause is
irregular vaginal bleeding.  Approximately 5% of endometrial cancers appear
before age 40. When detected early, a patient with endometrial cancer has a
favorable prognosis for cure. Risk factors associated with an increased risk for
endometrial cancer include:

  • Obesity
  • Anovulation
  • Nulliparity (no pregnancy)
  • Late menopause
  • Unopposed estrogen therapy
  • Family history
  • Personal history of breast, colon or ovarian cancer
  • Hereditary nonpolyposis colon cancer (HNPCC)
  • Tamoxifen therapy

Unopposed estrogen (ingested or produced endogenously) appear to be the
most frequent contributing risk factor associated with endometrial cancer.
Obesity and anovulation appear to have an endogenous source of estrogen
production. Tamoxifen (used for breast cancer treatment) appear to have an
anti-estrogenic effect on the breast and an estrogenic effect on the
endometrium. Estrogen related endometrial cancers tend to be well
differentiated and usually progress from endometrial hyperplasia to cancer
over a period of years. They tend to have a better prognosis than the
endometrial cancer that appears in a setting of atrophic or inert endometrium.

Premalignant lesions of the endometrium have been identified. The most
important is ‘endometrial hyperplasia’ and involves a proliferation of the
endometrial glands with varying degrees of architectural and cytologic
abnormalities. They include:

  • Simple hyperplasia (increased number of glands)
  • Complex hyperplasia (crowded glands)
  • Simple hyperplasia with atypia (prominent nucleoli)
  • Complex hyperplasia with atypia (crowded glands with prominent
    nucleoli)

After menopause, the endometrium (uterine lining) progressively atrophies
and becomes thinner (less than 5 mm).  Ultrasound (abdominal or vaginal),
computed tomography (CT) scan and magnetic resonance imaging (MRI) can
detect abnormal thickening of the endometrium. The upper limits of normal
thickness in a postmenopausal woman has been suggested at 8 mm
regardless of any ingestion of external hormonal therapy. Endometrial
hyperplasia is usually accompanied by increased endometrial thickening.
Endometrial biopsy (office procedure) or a dilatation and curettage (D&C) are
the preferred diagnostic methods to obtain tissue for pathological evaluation.

The most common types of endometrial cancers include:

  • Endometrioid adenocarcinoma (~ 80%)
  • Serous papillary carcinoma (5%-10%)
  • Clear cell carcinoma (less than 5%)
  • Other (mucinous, squamous cell, small cell)

Prognosis for cure of endometrial cancer is proportionally related to the stage
at the time of diagnosis. Staging is performed with the aid of CT and MRI
include:

  • Stage I:   Cancer confined to the corpus of the uterus
       o        Stage IA:  Tumor limited to the endometrium
       o        Stage IB:  Tumor extends into less than one half the
                                  width of   the myometrium (muscle of the uterus)
       o        Stage IC:  Tumor extends into one half or more of the
                                  myometrial width
  • Stage II:   Cancer involving the corpus and cervix, without extrauterine
                 spread
       o        Stage IIA:  Cancer extends only to the endocervical glands of
                                  the cervix
       o        Stage IIB:  Cancer extends into the fibromuscular tissue of the
                                  cervix
  • Stage III:  Cancer extending outside the uterus but confined to the true
                 pelvis
       o        Stage IIIA:  Cancer extends outside the uterus into the
                                   parametria
       o        Stage IIIB:  Vaginal metastasis of the endometrial cancer are
                                   present
       o        Stage IIIC:  Enlarged pelvic and/or para-aortic lymph nodes
                                   present
  • Stage IV:  Cancer invading the bladder or bowel mucosa and/or
                 spreading outside the true pelvis
       o        Stage IVA: Tumor invasion into the bladder or bowel mucosa
       o        Stage IVB:  Metastasis outside the true pelvis

If you believe that you or your loved have been misdiagnosed or wrongly
treated for endometrial cancer and suspect the injury may be the result of a  
gynecologic error that was diagnosable, avoidable and/or preventable, you
may have a valid cause of action. The injury may be the result of a medical
provider's mistake in handling your gynecologic condition and the result of
medical negligence.
Dr. Borten has over 35 years of experience as an
obstetrician and gynecologic surgeon to fully evaluate the merits of your
potential case. Allow the Boston area medical malpractice attorneys at
Gorovitz & Borten help you assert your rights and get the compensation you
deserve.
Contact Information
For a free confidential consultation and receive a response within 24 hours
(when possible), please contact us by phone, fax or e-mail with your question or
concern.

Telephone:  781-890-9095     -     Fax:   781-890-9098
                                                                                
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