Oncology (General Cancer)/Endometrial cells on Pap


I am 50 years old; my periods stopped for 4 months and then I had a period shortly after the pap was done. Endometrial cells were found and my GYN ordered a transabdominal/transvaginal sonography with 3D reconstruction; I have not received any guidance from my Dr., so I picked up the report today and I need your help on what I might expect to happen next or I should seek input for.

Here's the report:
Anteverted uterus measuring 8cm y 4.6 cm in AP diameter and 5.7 cm in transverse.Echo is homogeneously echogenic and measures 9mm in AP diameter.Consistent with unopposed estrogen stimulation. A hypoechoic nodular area seen w/i the cavity of the lower uterine body measuring 1.5 x 0.5 in diameter. color doppler suggests some associated vascularity. At least one tiny cystic area seen associated with this structure. most likely a polyp. Cervix unremarkable. R ovary 3.6 x 1.4 x 1.8 cm; anechoic cyst containing some echoes is seen w/i the ovary measuring up to 1.4 cm consistent with a physiologic cyst.  L ovary 1.3 x 0.6 x. 0.5. No evidence of free intraperitoneal fluid.
Impression: Unopposed estrogen stimulation of endometrium in view of the pts. perimenopausal status.  endometrial polyp suggested. Saline instilled sonohysterography would be helpful for confirmation.

My questions specifically: I have no hx of cancer or hormone replacement therapy; I take no meds and have no chronic conditions. P4, G4.  7 pound weight gain over 6-9 months, mild low back pain from time to time, but no other symptoms.

What is my uterine cancer risk? What would the next course of treatment typically be? What kind of time frame should a treatment decision be made?
I need to locate a new physician because my GYN still hasn't called to talk with me about this test and I've lost all trust in her.
Thank you!

I don't see anything on the report that makes me worry about cancer.  Endometrial cells found on a pap smear don't really mean anything at your age.  Endometrial polyps are generally not cancerous.  Your ovarian cyst is probably just a cyst, and they come and go all the time in most women.  sonohysterography would be reasonable, or simply repeating the ultrasound in three or four months.  Endometrial cancer is generally slow and orderly, unlike many other cancers, so you aren't risking much to wait.  All in all, I'm not worried.  
Next time you call your physician's office, ask the person who answers the phone to give you the name of another gyn, since yours won't return the calls.  I guarantee that will get some action.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

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