Gynecologic Tumors

Breast cancer.

Breast cancer, while not in the gynecologic group, is the most prevalent cancer in women and starts in breast tissue.

If it starts in a milk duct and hasn’t grown beyond, it’s ductal carcinoma in situ. Invasive breast cancer spreads into surrounding tissue; if it spreads via lymph/blood it’s metastatic breast cancer.

What are the types of breast cancer?

Types depend on which breast cells become malignant:

• - Ductal carcinoma: starts in ducts; most common.
• - Lobular carcinoma: starts in lobules; more often bilateral than other types.
• - Inflammatory breast cancer: cancer cells block lymph vessels; breast is red, warm, swollen. Rare.
• - Paget disease of the breast: affects nipple and areola skin. Rare.

Ovarian cancer.

Less common but causes more deaths than other reproductive cancers. Hard to detect early; often advanced at diagnosis.

Frequent symptoms:

• - Pelvic heaviness.
• - Lower abdominal pain.
• - Vaginal bleeding.
• - Weight gain or loss.
• - Abnormal periods.
• - Unexplained back pain that worsens.
• - Gas, nausea, vomiting, or loss of appetite.

Diagnosis: physical and pelvic exam, labs, transvaginal/pelvic ultrasound, etc. Treatment usually surgery followed by chemo.

Uterine cancer.

Most common type starts in the endometrium. Symptoms:

• - Abnormal vaginal bleeding or discharge.
• - Trouble urinating.
• - Pelvic pain.
• - Pain during intercourse.

Often after menopause; more common with obesity. Higher risk with prolonged estrogen-only HRT.

Tests: pelvic exam, imaging, biopsy. Common treatment: hysterectomy (sometimes ovaries/tubes removed). Others: hormone therapy, radiation, chemo.

Vulvar and vaginal cancer.

Rare cancer forming in the vulva. Grows slowly; precancerous lesions (dysplasia) may appear first.

Early symptoms can be minimal. See your doctor if you notice:

• - A lump on the vulva.
• - Itching or pain on the vulva.
• - Bleeding outside menstruation.
• - Skin changes on the vulva (different color, wart-like growths or ulcers).

Higher risk with HPV infection or history of genital warts.

Diagnosed with physical exam and biopsy. Treatment depends on stage/health: surgery, radiation, or chemo.

Benign breast tumors (Fibroadenomas, phyllodes tumor)

Benign growths of breast tissue; fibroadenomas are most common.

Main symptom: firm, painless, mobile lump in the breast.

Cause unclear; possibly hormonal. More frequent in puberty and pregnancy; less after menopause.

Preventive habits: self-exam, healthy diet, reduce fats/carbs, avoid caffeine/chocolate, avoid very tight bras.

Habits that may help prevent or reduce discomfort:

• - Breast self-exam regularly.
• - Healthy diet; reduce excess fats and refined carbs.
• - Limit caffeine and chocolate to avoid overstimulating breast tissue.
• - Avoid very tight bras that block circulation.

Diagnosis with ultrasound and, if needed, needle biopsy. Often resolve on their own; surgery if they grow fast or cause discomfort.

Always get medical evaluation if you suspect a breast tumor.

Ovarian cysts.

Most are small and asymptomatic; found during pelvic exams.

If symptoms appear, they may include:

• - Pressure or bloating.
• - Inflammation.
• - Pain in the lower abdomen on the cyst side.

Rarely cancerous; risk increases with age.

PCOS can cause many small cysts with hormonal and menstrual changes.

Premalignant lesions of cervix, vulva, and vagina.