Dr. George on Improving Methods of Diagnosis for Uterine Leiomyosarcoma

Suzanne George, MD
Published: Wednesday, Jan 09, 2019



Suzanne George, MD, assistant professor of Medicine, Harvard Medical School, clinical director, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, discusses improving methods of diagnosis for women with uterine leiomyosarcoma.

There are several reasons why preoperative diagnosis is challenging, says George. In contrast with endometrial carcinoma which starts in the lining of the uterus, uterine leiomyosarcoma starts in the wall of the uterus. Sometimes endometrial biopsies can identify a uterine leiomyosarcoma, but they are not reliable because leiomyosarcoma resides outside of the parameters of the biopsy, she explains.

Novel diagnostic imaging or optimization of MRIs are being explored as potential alternatives. Others have looked at various blood tests to see whether a combination of MRI and blood tests may be more effective, explains George. To date, none of these methods are ready to be translated to clinical practice.

In women who go to hysterectomy for symptomatic fibroids, the risk of a leiomyosarcoma being identified is estimated to range from 1 in 300 to 1 in 500. Therefore, physicians need to find better methods for identifying those patients who are at high risk and improve collaboration within the field in order to offer the best care possible to patients.
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Suzanne George, MD, assistant professor of Medicine, Harvard Medical School, clinical director, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, discusses improving methods of diagnosis for women with uterine leiomyosarcoma.

There are several reasons why preoperative diagnosis is challenging, says George. In contrast with endometrial carcinoma which starts in the lining of the uterus, uterine leiomyosarcoma starts in the wall of the uterus. Sometimes endometrial biopsies can identify a uterine leiomyosarcoma, but they are not reliable because leiomyosarcoma resides outside of the parameters of the biopsy, she explains.

Novel diagnostic imaging or optimization of MRIs are being explored as potential alternatives. Others have looked at various blood tests to see whether a combination of MRI and blood tests may be more effective, explains George. To date, none of these methods are ready to be translated to clinical practice.

In women who go to hysterectomy for symptomatic fibroids, the risk of a leiomyosarcoma being identified is estimated to range from 1 in 300 to 1 in 500. Therefore, physicians need to find better methods for identifying those patients who are at high risk and improve collaboration within the field in order to offer the best care possible to patients.



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