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When we hear about cancer, we immediately think about the worst. Some changes, however, are mild. However, that doesn’t mean we can ignore them. Annual gynecological ultrasound examinations combined with cytology are a standard in caring for women’s health. Thanks to the wide availability of ultrasound, we can detect changes of very small dimensions, even before the appearance of disturbing symptoms.
Numbers rule the world, including the medical world. When we start reading a scientific study on a specific disease entity, we usually find references to its frequency in the first paragraph. Why do we use numbers so often in medicine when they don’t play a role in treatment? It’s simple – to better present the scale of the analyzed problem. From my observations, the use of the phrase 1 in 10 or 000 percent. is not very convincing – we always assume that it is not us or our family that will be just this one case, but if we translate these numbers into our immediate surroundings and understand that it is very likely that one of our relatives will be diagnosed with the disease, then we will receive the whole paragraph changes dramatically.
Why am I mentioning this? Well, the very high incidence of uterine fibroids or ovarian cysts makes you surely know a woman who has experienced or will experience a suspected benign tumor of the reproductive organ found during an ultrasound examination.
Benign neoplasm – what does it mean?
We associate the word “cancer” only with “cancer” and a very bad prognosis. Paradoxically, many types of benign neoplasms located in various tissues appear in our body throughout our lives. Such changes can be moles on the skin or lipomas in the subcutaneous tissue.
According to medical knowledge and histopathological assessment, they are benign neoplasms because they are clusters of abnormal cells that do not fulfill their function. Whereas the main difference between a benign tumor and a malignant tumor (i.e. cancer) is that it does not invade surrounding tissues and spread as metastases.
Since benign tumors do not usually threaten our health, does it make sense to observe / treat them? Yes it is – there are at least two reasons for this.
First, any benign lesion can transform into a malignant neoplasm. Despite the fact that the risk is usually less than 1%, it should always be kept in mind when deciding on treatment. Only collecting samples and examining them under a microscope allows us to finally diagnose and exclude the malignant process.
Secondly, benign neoplasms can become large over time and compress the surrounding tissues, which adversely affects the functioning of neighboring organs and reduces the quality of life.
Nowadays, ultrasound is a widely available, possibly the least invasive and widely accepted by patients imaging method, which in many cases allows the detection of very small changes in female organs (long before symptoms appear).
The most common, benign neoplasms diagnosed during prophylactic gynecological ultrasound examinations include: uterine fibroids, ovarian cysts and endometrial polyps (a small reminder – ultrasound does not detect cervical cancer!).
The most common abnormalities in ultrasound
Uterine fibroids are tumors made up of abnormal muscles inside the womb. Their number, size and location may affect your health and cause certain symptoms: heavy anemia, difficulties in getting pregnant, pain in the lower abdomen and painful intercourse. Some fibroids can reach a diameter of even several centimeters, and the uterus can be as large as in the second trimester of pregnancy!
It is estimated that fibroids may affect up to 30-40 percent. women of childbearing ageand taking into account the symptoms they are associated with, they constitute a significant social problem. Fortunately, most fibroids do not require surgery, but only ultrasound observation. It is thanks to the ultrasound assessment that we can make a diagnosis, assess indications and choose the appropriate method of treatment (if necessary).
Ovarian cysts is a topic that probably will not be exhausted by even an extensive monograph. The most common type of cysts diagnosed in ultrasound are the so-called simple cysts (containing fluid and associated with a low probability of a malignant process). Often in the descriptions of the abdominal ultrasound or computed tomography we can find a description of a cyst with a diameter of, for example, 28 mm. It is worth remembering that fluid changes 20-30 mm in the area of the ovaries in menstruating women are nothing more than maturing ovarian follicles or functional changes that disappear during subsequent cycles.
On the other hand, there are real indications for surgical treatment when a cyst is found if its diameter exceeds 40 mm or when a malignant lesion is suspected (due to its large size or the presence of several chambers with solid elements). Unfortunately, as in the case of other benign neoplasms, we cannot make sure that a given cyst is only a benign lesion, so the only way to find out about it is to remove it surgically.
Endometrial polyps are changes that are smaller in size than uterine fibroids or ovarian cysts, but can have symptoms such as abnormal bleeding between periods and infertility. Due to their small size, in order to make an accurate diagnosis, ultrasound should be performed in the first phase of the cycle (preferably right after the end of menstruation) – otherwise, the growing endometrium may mask their presence. Compared to the above-described benign neoplasms, their symptoms are more discreet, although the diagnosis is the most difficult. Contrary to fibroids or cysts, we always decide to remove them – the method of choice is surgical hysteroscopy.
Regular examinations are essential
Due to the high frequency of benign tumors of the reproductive organ and cyclical changes throughout life, tens of thousands of women in Poland have to face this diagnosis every year. Fortunately, the diagnosis of a myoma, cyst or polyp is a diagnosis that is usually associated with a good prognosis and a low risk to health.
On the other hand, it is worth remembering that not every lesion requires urgent surgical treatment, but only more frequent checks and monitoring in ultrasound.
Finally, a return to the numbers – it is possible that you will meet with such a diagnosis at your address. In such a situation – keep your head up! Thanks to the appropriate diagnostics, you will find out about it soon enough, and your recovery will be faster than you expected!
Author: Michał Lipa, MD, PhD, XNUMXst Department of Obstetrics and Gynecology, Medical University of Warsaw
The article comes from the campaign «W trosce o women» prepared by Warsaw Press and whose media partner is MedTvoiLokony. All materials can be found at http://kobieta.warsawpress.com/
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