Hyperplasia without atypia

In 2001 I had a D&C to discover the cause of my flooding periods. Dr. removed several polyps. Pathology report was benign, but did show simple hyperplasia. Second opinion on pathology showed atypia, but pathologist, who specializes in gyn path at the Univ. of MD medical school, considered it benign.
In April I had a second D&C because of intermittent bleeding. Fortunately heavy bleeds never recurred. I was 55 at the time and still in perimenopause. Different pathologist at same hospital now saw complex hyperplasia, which my dr. interprets as an increased risk for uterine cancer and a good reason for a TVH. Second opinion makes no mention of complex hyperplasia not atypia from the first go around.
I'm consulting with a gyn oncologist two weeks before scheduled surgery date. He comes highly recommended, but will be out of town for three weeks so I can't get in sooner. I've also requested a follow up ultrasound to check on the progress of two fibroids.
Did any of you go through this scenario? I'm strongly reconsidering mu decision to have the surgery, but will go through with it if second dr. agrees.

Chuckies

I was diagnosed with complex endometrial hyperplasia, NO atypia. From what I've read at Sorting out Hyperplasia the lack of atypia makes the chance of cancer somewhere around 3%. When there is atypia that chance rises.

As far as I was concerned that was too great a risk to take with my health. I have a grandmother who died from uterine cancer (paternal, but nonetheless, that's what killed her) and my Doc felt/told me it was a pre-cancerous condition. Your mileage will, of course, vary!

If you opt not to have the hysterectomy then you will need to plan for regular endometrial biopsies to keep a close watch for atypia, approx. 25-30% of those cases will progress to endometrial cancer.

Only you can make the decision, but I hope this information might help a little

Chris

Thanks, Chris. Your reply and the link are very helpful!

Hey sweetie! Just wanted to add my two cents. One of my rx that came back with my tah/bso last monday was complex atypia endometrial hyperplasia, which my dr stated was a precancerous condition. Luckily no bad boys were in there. Whew! I just turned 26, and was diagnosed with the adeno and that when i was 19 after the birth of my son. I know everyone is different, so just ask your dr what is best for you. There are tons of links out there about endometrial hyperplasia, as well as tons of support in here to help you with your decision. I have been told that in my case I had way too much estrogen. I am now taking hrt called activella, which is meant for menopausal women with a uterus. Maybe you could go on some sort of hrt to help you if you don't want to have a hyster. Anyway, hope that all goes well with you and good luck.

Thought I would let you know that I did have complex hyperplasia with atypia and my gyn pretty much said that if it is simple you keep testing but when it becomes complex with atypia it is a case of not if but when it will turn into cancer. that is his explanation to me. He wanted to do Hyst within 30 days and so I did. TVH BSO removed uterus, cervix, ovaries and tubes. The path report did show complex hyperplasia with atypia, dysplasia of the cervis, fibroids, adenomyosis. The only dx I had prior to surgery was the hyperplasia the others were a surprise, lol.

I am 52 yo and have had several PAP smears that were questionable, had cervix frozen at one point, etc., etc., so I did not want to chance it. Interestingly enough, my sister has just been diagnosed with simple hyperplasia.

The TVH BSO went smoothly, recovery was uneventful, never had any discharge, bleeding, infection, etc. A lot of fatigue the first 4 weeks and still if I do to much. It has been 6 weeks today since my surgery.

Gather all the facts and follow your gut instinct is my suggestion.

Marci

Thanks, Marci, for your common sense response. And the fact that you are recovering so nicely is very encouraging.

Hi Chuckies,

I was diagnosed with hyperplasia in 1994. I was never told what kind I had and was never given any follow-up - but went on to develop endo cancer anyway!

If you do decide against the hyster, make sure that they check you out regularly!

You can read my full story under another thread:-

https://www.hystersisters.com/vb2/sho...513#post346513