08 - Radiol Clin N Am 2007 - Imaging of Uterine Cancer

16 Pages·2007·1.24 MB·English

Imaging of Uterine Cancer

Oguz Akin, MDa,b,*, Svetlana Mironov, MDa,b,
Neeta Pandit-Taskar, MDa,b, Lucy E. Hann, MDa,b

Endometrial cancer

The American Cancer Society estimates that in
2006, 41,200 new cases of cancer of the uterine cor-
pus, mostly endometrial, will be diagnosed and
7350 women will die from this disease in the
United States [1].
Endometrial cancer may develop from endome-
trial hyperplasia caused by unopposed estrogen
stimulation; it also may develop spontaneously.
Risk factors for developing endometrial cancer
include conditions leading to increased estrogen
exposure, such as estrogen replacement therapy
(without progestin), obesity, tamoxifen use, early
menarche, late menopause, nulliparity, and history
of polycystic ovary disease. Pregnancy and use of
oral contraceptives reduce the risk of endometrial
cancer.
Up to 90% of endometrial cancers are adenocar-
cinomas. Depending on the glandular pattern, they
are classified as well-differentiated (grade 1) to an-
aplastic
(grade
3)
tumors.
Prognostic
factors

include tumor grade and stage, depth of myome-
trial invasion, and lymph node status.
Most endometrial cancers are detected at an early
stage because of clinical assessment for postmeno-
pausal bleeding. Treatment options include surgery,
radiation, hormones, and chemotherapy, depend-
ing on the stage of the disease.
The 1-year relative survival rate for uterine corpus
cancer is 94%. The 5-year survival rate is 96% for
local disease, but it decreases to 66% for disease
with regional spread and 25% for disease with
distant spread.

Cervical cancer

The American Cancer Society estimates that in
2006, 9716 new cases of invasive cervical cancer
will be diagnosed and 3700 women will die from
this disease in the United States [1]. As Papanico-
laou (Pap) smearing has become more common,
incidence rates of cervical cancer have decreased
and preinvasive lesions of the cervix are far more

R A D I O L O G I C
C L I N I C S
O F N O R T H A M E R I C A

Radiol Clin N Am 45 (2007) 167–182

a Weill Medical College of Cornell University, New York, NY, USA
b Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY
10021, USA
* Corresponding author. Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York
Avenue, New York, NY 10021.
E-mail address: