Gynecologic Oncology

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With the media attention focused on cancer genes and registries aimed at tracing hereditary cancers, many women with a family history of cancer and some with no such history are asking their physicians for advice and testing. This article explains the nature of breast and ovarian cancer inheritance and gives recommendations for screening and intervention based on the latest findings in this fast-changing field.

During colposcopy the practitioner must determine the surface extent of the lesion; identify the most abnormal colposcopic area(s) for biopsy(ies); and identify any areas suspicious for invasive cancer. After histological reporting, correlation determines whether the lesion can be safely ablated or if it must be excised to ascertain if a microinvasive or frankly invasive cancer is present. Patients usually present with abnormal cytology suggesting squamous disease of some grade.

We are coming out of a dust bowl. When I was asked to write an article on the recent history of biofeedback for treating incontinence and the reimbursement associated with it, my first thought was that it's been a dust bowl. For the last five years we have been working with OB/GYNs, urogynecologists, and urologists from across the country who provide biofeedback.

Ovarian carcinomas from 30 BRCA1 germ-line carriers of two distinct high penetrant founder mutations, 20 carrying the 1675delA and 10 the 1135insA, and 100 sporadic cases were characterized for somatic mutations in the TP53 gene. We analyzed differences in relation to BRCA1 germline status, TP53 status, survival and age at diagnosis, as previous studies have not been conclusive.

The aim of this study was to investigate the occurrence of (pre)neoplastic lesions in overtly normal Fallopian tubes from women predisposed to developing ovarian carcinoma. The presence of (pre)neoplastic lesions was scored in histological specimens from 12 women with a genetically determined predisposition for ovarian cancer, of whom seven tested positive for a germline BRCA1 mutation.

The view that nuns have a very low risk of cervical cancer is questioned. The historical evidence for this view is reviewed, from the beginning of the eighteenth century to the present. An estimate of the actual mortality rate from cervical cancer suggests that risk of death from this neoplasm among nuns is little different from that among the general female population.

In this column, subject experts have been invited to provide an annotated guide to some of the most useful health sites on the Internet. In this issue Hans van der Slikke, Consultant Obstetrician at Zaandam Hospital, The Netherlands, and Chairman of the International Council of OBGYN.net, provides a guide to some of the best women's health resources now available on the Internet.

Although sperm and embryos (fertilized eggs) have been successfully frozen and subsequently thawed to create healthy children for decades, it is only recently that successful human egg freezing has become a reality.

Susan is a 58-year-old woman who saw her family physician after a few weeks of mild abdominal pain and bloating. The examination of her abdomen was normal, as was a pelvic and rectal exam. Blood tests for infection, liver and gall bladder problems were also normal.

There are many ways to treat cervical dysplasia (CIN). Factors influencing the choice of treatment for cervical dysplasia include the extent and severity of the dysplasia, the age of the woman, and whether or not she has any other gynecological problems.