"Complex" Ovarian cyst

From Johns Hopkins Ovarian Cancer Site:

How accurate is a CA 125 test for ovarian cancer?

The CA 125 test only returns a true positive result for about 50% of Stage I ovarian cancer patients. The CA 125 test is not an adequate early detection tool when used alone.

The CA 125 test has an 80% chance of returning true positive results from stage II, III, and IV ovarian cancer patients. The other 20% of ovarian cancer patients do not show any increase in CA 125 concentrations.

However several gynecological disorders can cause a false positive result. Endometriosis, benign ovarian cysts, first trimester of pregnancy, and pelvic inflammatory disease all produce higher levels of CA 125.

70% of people with cirrhosis, 60% of people with pancreatic cancer, and 20%-25% of people with other malignancies have elevated levels of CA 125.

A study of about 22,000 post menopausal women 45 years or older screened about 11,000 with the CA 125 test. 468 patients with elevated CA 125 levels were given an ultrasonography test. Of those patients, 29 underwent surgical procedures. 6 had ovarian cancers, 2 had adenocarcinoma of unknown origin, 14 had benign cancers, 4 had fibroids, and 3 had no abnormalities.

CA 125 test has a lower specificity in premenopausal women than postmenopausal women.

The CA 125 test is not recommended for use alone as an early detection method. The rate of false positives is very high, and there has been no data concerning change in mortality.

The CA 125 test should not be used alone to detect ovarian cancer, but rather with transvaginal sonography and rectovaginal pelvic examination for greater accuracy.

Combining detection methods lowers the number of false positive results.

The CA 125 test should be done serially for best accuracy.

Hello to another Hyster Cyster!

I also had complex cysts and a history of ovarian cancer (my mom) and breast cancer (me). Given such a history I had both ovaries removed (among other things). In my case it was not cancer - there was an endometrioma (2 cm) on the left side and a mucinous cystadenoma (4.5 cm x 9.1 cm) on the right side. There are a few other non-cancerous possibilities for complex cysts including dermoid cysts. I 've seen one study where 94% of the complex cysts removed were benign.

Nonetheless, I am glad I had the ovaries removed. Definite benefits in the peace of mind department. Now I can worry a lot less about ovarian cancer (although there still remains a slight chance of it developing).

I guess the good news is that even with complex cysts the risk of cancer is low; the bad news is that with a family history the risk is definitely higher.

I hope I am not just adding to your confusion. I guess my take home message is relax (OK, try to relax) it's probably not cancer, but with a family history its best to know for sure (i.e. yank those puppies out).

Good luck at the castle!