Lesson 1, Topic 1
In Progress

Cancers of the Female Reproductive System

April 11, 2024

Learning Objective: Examine the cancers found in the female reproductive system.
      Cancer can be found in many different body systems, including the female reproductive system. The following sections discuss the most common cancers found in this system.

Breast Cancer
Learning Objective: Describe breast cancer.
      Breast cancer is the second leading cause of cancer deaths in women. According to the American Cancer Society, 1 in 8 women have a lifetime risk of developing breast cancer, and 1 in 39 risks of dying from the disease.
      It is not known what causes breast cancer. Risk factors include being female, a family history of breast cancer, inherited genes, radiation exposure, obesity, menarche at a younger age, menopause at an older age, having your first child at an older age, having never been pregnant, postmenopausal hormone therapy, and drinking alcohol. Signs and symptoms include a breast lump or thickening; change in the size, shape, or appearance of a breast; changes to the skin over the breast, such as dimpling, a newly inverted nipple, peeling, scaling, or flaking of the pigmented area of the skin surrounding the nipple (areola) or breast skin; and redness or pitting of the skin over the breast.

      Diagnostic procedures start with a breast examination by the provider and may also include a mammogram, breast ultrasound, biopsy, or breast magnetic resonance imaging (MRI). Surgical treatment could consist of a lumpectomy, mastectomy, or sentinel node biopsy. Some women with cancer in one breast choose to have the other breast removed (contralateral prophylactic mastectomy). Treatment could also include radiation, chemotherapy, or hormone therapy.

Cervical Cancer
Learning Objective: Describe cervical cancer.
      Almost all cervical carcinomas are caused by the human papillomavirus (HPV). The first stage of cervical cancer is asymptomatic, but early diagnosis of cervical cellular changes is possible with a Papanicolaou (Pap) test, and HPV can be detected with HPV testing.
      The causes of cervical cancer are not known, but HPV is known to play a role. Risk factors include many sexual partners, early sexual activity, having other STIs, a weak immune system, and smoking. In the early stages of cervical cancer, the patient is asymptomatic. In the advanced stages, signs and symptoms include vaginal bleeding after intercourse, between periods, or after menopause; watery, bloody vaginal discharge that may be heavy and have a foul odor; and pelvic pain or pain during intercourse.
      A Pap test is the most common screening test. From the same sample, an HPV test can be done. Diagnostic tests include a punch biopsy, endocervical curettage, colposcopy, and loop electrosurgical excision procedure (LEEP). The LEEP procedure can also be a treatment that removes all of the cancer cells. Other treatment options include cone biopsy, hysterectomy, radiation, and chemotherapy.

Ovarian Cancer
Learning Objective: Describe ovarian cancer.
      Ovarian cancer causes more deaths than any other cancer of the female reproductive system, but it accounts for only about 3% of all cancers in women. Most of the time, the cancer has already metastasized before the tumor is diagnosed.
      It is not known what causes ovarian cancer. Risk factors include age, inherited gene mutation, estrogen hormone replacement therapy, menarche at a young age, menopause at an older age, having never been pregnant, fertility treatment, smoking, use of an intrauterine device, and polycystic ovary syndrome. In the early stages of ovarian cancer, the patient is asymptomatic. In the advanced stages, signs and symptoms can include abdominal bloating, quickly feeling full when eating, weight loss, discomfort in the pelvis area, changes in bowel habits, and a frequent need to urinate.
      Diagnostic procedures include a pelvic examination, ultrasound, or computed tomography (CT) scan, cancer antigen 125 (CA-125) blood test (which looks for certain proteins in the blood), and a biopsy. Surgical treatments include hysterectomy, unilateral salpingo-oophorectomy, or bilateral salpingo-oophorectomy. Chemotherapy and targeted drug therapy may also be used in the treatment of ovarian cancer.

28.5 Critical Thinking Application
A patient is being seen in the OB/GYN department after having an abnormal Pap test, and Dr. Walden had recommended a LEEP procedure. Jill is wondering why a LEEP was recommended instead of a c