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Hyperplasia, Atypia, and Gynecologic (GYN) Cancer

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Is hyperplasia with atypia cancer or not?I have been diagnosed with hyperplasia with atypia. Is this cancer or not?

Endometrial hyperplasia is an abnormal overgrowth of the endometrium (lining of the uterus) resulting from prolonged stimulation by estrogen without the proper changes in progesterone levels to trigger regular menstrual bleeding. This causes the endometrium to thicken and become glandular. This is hyperplasia, which may also be a premalignant lesion. In other words: it is not cancer, but it may be a precancerous condition. In about one in four cases, these lesions do become cancerous, so it is certainly something to take seriously.

There are four types of endometrial hyperplasia, some more concerning than others.
Hyperplasia can be either simple or complex. Simple hyperplasia usually refers to the buildup of extra cells in the endometrium without other changes in the structure of the uterine lining. Complex, or glandular, hyperplasia includes both a buildup of cells and the formation of glandular tissue. Women are more susceptible to both forms of hyperplasia during perimenopause, the years just prior to menopause, when menstruation becomes irregular. Post-menopausal women on hormone replacement therapy also have an increased risk for developing hyperplasia.

Atypia refers to the presence of abnormal, possibly precancerous cells in your biopsy. The presence of atypia increases the chance that hyperplasia will develop into malignant tumors.

Simple and complex hyperplasia without atypia together carry just a 3% risk of developing into endometrial cancer. This is about the same risk as a woman without hyperplasia, so hyperplasia without atypia is not considered a precancerous condition. Most gynecologists will recommend treating these conditions with progestin therapy to trigger the sloughing off of the endometrial lining as occurs during regular menstruation.

Hyperplasia with atypia, however, is considered precancerous. The presence of atypical cells means that you and your doctor will want to treat your hyperplasia more aggressively and keep a careful eye on its development. Simple hyperplasia with atypia can be treated with progestin therapy and has a less than 10% chance of developing into cancer. Complex hyperplasia with atypia, though, carries a 25–30% chance of developing into cancer, and in some cases preexisting cancerous cells are detected during treatment. The more advanced and severe the atypia is, the more likely it is to develop into cancer. Many gynecologists will recommend hysterectomy for complex hyperplasia with atypia.

Consult with your doctor and seek a second opinion if you are unsure about the path he or she is recommending.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

08-03-2011 - 03:16 AM


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