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complex hyperplasia with atypia complex hyperplasia with atypia

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Unread 07-06-2002, 10:32 AM
complex hyperplasia with atypia

Does anyone have experience with this? I would like to know what tests should be done. I have only had an EMB. Doctor says the way they find out if it's cancer is from the biopsy when they remove the uterous, ovaries, cervix, tubes. I would feel better having a D & C, CT scan, MRI and lap first.

Any thoughts on this? Thank you.
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Unread 07-06-2002, 06:39 PM
Hi Again Judy!

I did not have this, but from what I understand, endometiral hysperplasia is very hard to distinguish from early carcinoma.The hyperplasia, which causes the organ to increase in size due to increased number in size, can range from simple gladular crowding, to atypical cell structure. I don't know how much research you have done, but if you have only the medical advice of one Dr. and you are seeing a gyne- oncologist on July 9th, this might be at the top of your question list. I had hyperplasia of the lymph nodes in my armpit. Although the risks and lifetime effects of having my lymph nodes removed were dramatic, there was no way for the breast oncologist to get a specific diagnosis without taking out my nodes. (we did try a biopsy first )

Please bring your tablet with you and ask your new Doctor. Second opinions are always a good way to go! Take care and sss
Unread 07-06-2002, 09:33 PM

meant to say "increased number of CELLS"! Hard to post sometimes with my 18 month old at my feet!!!!
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Unread 07-07-2002, 05:51 AM
complex hyperplasia with atypia

Hi Judy,
Welcome to the board.

It certainly does throw you for a loop, doesn't it, to hear those words. I had a similar reaction to yours, though in my case it was this weird thing on my ovary that they weren't sure what it was, but it wasn't behaving like classic ovarian cancer. I too wanted to wait and see but I went for that second opinion like beachgirl says, who was a gyn oncologist, and he convinced me to have the hysterectomy. His gut instinct was right. I had borderline cancer, and I am so glad to have it out of me.

Cancer is a continuum, which means that it starts with regular cells multiplying too fast and moves into cells getting a little strange to cells getting really strange to full-blown cancer cells but with clear margins and finally to cancer cells on the loose.

So, you probably don't quite have cancer yet, but it's getting toward the jumping off point, and frankly, now is the time to get it the heck out of you before it takes off.

I've checked some of the statements in the medical school sites about the accuracy of an EMB, and it's 90%-98% accurate.

A CT scan can really only image masses of an inch or larger. By the time they show up on the CT scan, it's much much later than the stage you're at and it's full blown aggressive cancer. My understanding is that MRI is the same problem. You do not want to wait for something to show up on those.

If the lab is confident of the EMB results, the doctors will be reluctant to do another test because of the high accuracy. Though I could find some endorsement of a hysteroscopic examine with sampling, if your cancer is still early, which it sounds like it is, it won't reveal anything more. A D&C is the suggested follow-up for an uncertain EMB listed in the Merck Manual. If you need a confirmation before agreeing to surgery, that would be the next step, it seems.

However, another procedure, with a lot of anesthesia, will just delay things. And if you act now you might be able to avoid radiation and have it solved with surgery alone. Of course, see what the gyne/oncologist says, but don't feel that they are blowing you off by wanting to rely on the EMB.

So I'd go get that second opinion, bring that like beachgirl says (I sure took mine), and maybe even a second pair of ears-- the gets dense when in the doctor's office!

At the top of this forum are a list of links we've found helpful. Do read up on your condition.

Let us know what happens.
Unread 07-09-2002, 04:16 PM
complex hyperplasia with atypia

I run the risk of sounding stupid, but what is an EMB? I have been diagnosed with the above mentioned condition. I have had ultrasounds, D&C, hysteroscopy. The Gyn Ono suggested 3 months of progesterone with a follow-up hysteroscopy and D&C. That will take place at the end of August. I also had a CA-125 which came back okay. I have days where the pain is not too bad, other days the pain is bad enough I have to take something for is to ease the pain. And everyday since my last D&C I have the strangest feeling of swelling (for lack of a better description) throughout my lower abdomen. I do have several ovarian cysts, some small, some larger. I guess we are playing the waiting game until by procedure in August.
Unread 07-10-2002, 05:50 PM
complex hyperplasia with atypia

I learn so much from this board. Thank you Beachgirl and Trish. Your answers have details in them that I guess doctors get tired of telling people because they don't have the time to sit down and discuss them with each patient.

To the last person who wrote, are you certain you have Complex Hyperplasia with Atypia? Or is it just Complex Hyperplasia?
An EMB is an endometrial biopsy. You have had lots of exploratory work it sounds like. The D & C is a large scale version of an EMB. I am going in for a Hysteroscopy and Laproscopy Tue. July 16th. I have had problems with allergies and drugs so am afraid, but looking forward to stopping the bleeding.

Thank you again for your answers!
Unread 07-11-2002, 12:21 AM
Hi Judy

You are Welcome! Glad to be of help! I have been thinking of you and I know you have a tough decision. You are smart to ask a lot of questions and feel comfortable with your decisions. I wish I would have taken more time, but I was too scared. I have a few regrets- I hope you won't. I unfortunately did not find this site for a few months after my hysterectomy! I was so confused !!!! Didn't you have you gyn-onc appointment today? Let us know. sss and sss
Unread 07-11-2002, 11:32 PM
complex hyperplasia with atypia

Hi Leslie,
Congratulations on your incredibly good news! I teared up. When you feel rested I hope you will celebrate. Good news like this is something to take time out for.

Re. the question on nodes, I feel mine at times. It is almost as if I have a flu and they are puffing up a little, but I can't feel a lump, it is more of a sensation.

I was going to get a laproscopy and hysterscopy(?) next Tues. but my husband thinks the risk of general anesthesia(sp?) isn't worth it. The doctor said in 25 years he has found 2 women where the pathology was "over read" as complex hyperplasia atypia, so they were able to avoid a hyster. He wanted to do a D & C on me also. I run a 5-10% risk of aortal aneurysm from general anesthesia, so my husband thinks I should just have the hyster., undergoing general anesth. once, not twice.

I am still fantasizing about taking hormones instead. One oncologist gives it 75% chance of working, another said 50%. Can a person have a D & C without general anesthesia?

Unread 07-11-2002, 11:49 PM

It is late, so I will write you a quick note. I had a fetus that stopped growing at four months. I had to have a D and C. I was offered general anesthesia or an epidural. I believe it is pretty common for women to ask to not go under for that procedure. My sister was sedated for her D and C as well. Thanks you for you positive thoughts. They mean a lot. I'll write more tomorrow. I have to be in L.A. for the taping of the Berman and Berman show on Hysterectomy. It will be airing on the Discovery Health Channel. I get to tell my story!!!! So, I must not have dark circles! It is off to bed for me
Unread 07-12-2002, 03:09 PM
complex hyperplasia with atypia

Hi Judy, I am new at this. I have had an EMB, just never heard it refered as such. I am currently on progestrone for 90 days (which is over at the end of August), at which time I will go for another hysteroscopy and D&C to get tissue for another biopsy. Thank you for the explaination.


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