Common gynecologic problems in geriatric-aged women

Clinical Obstetrics and Gynecology

Volumn 50, Issue 3, 2007, Pages 687-708

  Moroney, John W ^a   Zahn, Christopher M ^b  

^a UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER   (United States)

^b UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES   (United States)

Author keywords

Abnormal uterine bleeding; Adnexal cysts; Breast disease; Cervical disease; Geriatric aged women

Indexed keywords

ANASTROZOLE; GESTAGEN;

ADNEXA DISEASE; BREAST CANCER; BREAST DISEASE; CANCER SCREENING; DNA SCREENING; ENDOMETRIUM BIOPSY; ENDOMETRIUM HYPERPLASIA; GERIATRIC PATIENT; HEALTH CARE ORGANIZATION; HUMAN; HYSTERECTOMY; HYSTEROSCOPY; INCIDENCE; LAPAROSCOPY; MAMMOGRAPHY; OBESITY; PAPANICOLAOU TEST; POSTMENOPAUSE; REVIEW; UTERINE CERVIX CANCER; UTERUS BLEEDING; WART VIRUS;

AGE FACTORS; AGED; AGED, 80 AND OVER; BREAST DISEASES; DNA PROBES, HPV; ENDOMETRIAL HYPERPLASIA; FEMALE; GENITAL DISEASES, FEMALE; HUMANS; POSTMENOPAUSE; PRACTICE GUIDELINES; RISK FACTORS; UTERINE HEMORRHAGE;

EID: 34548380893     PISSN: 00099201     EISSN: None     Source Type: Journal    
DOI: 10.1097/GRF.0b013e3180d0a3f0     Document Type: Review

References (131)

1. Saslow D, Runowicz CD, Solomon D, et al. American Cancer Society Guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin. 2002;52:342-362.
2. American Cancer Society. Guidelines for the early detection of cancer. Available at: http://www.cancer.org/docroot/PED/content / PED_2_3X_ACS_Cancer_Detection_Guidelines_36.asp?sitearea=PED. Accessed March 18, 2007.
3. American College of Obstetricians and Gynecologists. Cervical Cytology Screening. ACOG Practice Bulletin Number 45. Washington, DC: American College of Obstetricians and Gynecologists; 2003.
4. American College of Preventive Medicine. Cervical cancer. Available at: http://www.acpm.org/cpscervicalcancer.htm. Accessed March 18, 2007.
5. American Academy of Family Physicians. Recommendations for clinical preventive services: cervical cancer. Available at: http://www.aafp.org/online/ en/home/clinical/exam/a-e.html. Accessed March 18, 2007.
6. Canadian Task Force on Preventive Health Care. Screening for cervical cancer. Available at: http://www.ctfphc.org/. Accessed March 18, 2007.
7. US Preventive Services Task Force (USPSTF). Screening for cervical cancer: recommendations and rationale. Released January 2003. Available at: http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.htm. Accessed March 18, 2007.
8. United Kingdom National Health Service (NHS) Cancer Screening Programme. Cervical cancer. Available at: http://www.cancerscreening.nhs.uk/cervical/index. html. Accessed March 18, 2007.
9. Australian Government Department of Health and Ageing National Cervical Screening Program. NHMRC cervical guidelines. Available at: http://www. cancerscreening.gov.au/internet/screening/publishing.nsf/Content/papsmear. Accessed March 18, 2007.
10. American College of Physicians. Screening for cervical cancer. In: Eddy DM, ed. Common Screening Tests. Philadelphia, PA: American College of Physicians; 1991:413-414.
11. Sawaya GF, Grady D, Kerlikowske K, et al. The positive predictive value of cervical smears in previously screened postmenopausal women: the Heart and Estrogen/Progestin Replacement Study (HERS). Ann Intern Med. 2000;133:942-950.
12. Cervical cancer. NIH Consensus Statement Online April 1-3, 1996;43:1-38. Available at: http://consensus.nih.gov/1996/1996CervicalCancer102html.htm. Accessed March 18, 2007.
13. Sawaya GF, Kerlikowske K, Lee NC, et al. Frequency of cervical smear abnormalities within 3 years of normal cervical cytology. Obstet Gynecol. 2000;96:219-223.
14. Koike N, Kasamatsu T. Efficacy of the Cytobrush method in aged patients. Diagn Cytopathol. 1994;10:311-314.
15. Saad RS, Kanbour-Shakir A, Lu E, et al. Cytomorphologic analysis and histological correlation of high-grade squamous intraepithelial lesions in postmenopausal women. Diagn Cytopathol. 2006;34:467-471.
16. Gupta S, Kumar N, Singhal N, et al. Cytohormonal and morphological alterations in cervicovaginal smears of postmenopausal women on hormone replacement therapy. Diagn Cytopathol. 2006;34:676-681.
17. Wright TC Jr, Cox JT, Massad LS, et al., for the 2001 ASCCP-Sponsored Consensus Conference. 2001 consensus guidelines for the management of women with cervical cytological abnormalities. JAMA. 2002;287:2120-2129.
18. American College of Obstetricians and Gynecologists. Management of Abnormal Cervical Cytology and Histology. ACOG Practice Bulletin Number 66. Washington, DC: American College of Obstetricians and Gynecologists; 2005.
19. Mount SL, Wegner EK, Eltabbakh GH, et al. Significant increase of benign endometrial cells on Papanicolaou smears in women using hormone replacement therapy. Obstet Gynecol. 2002;100:445-450.
20. Solomon D, Schiffman M, Tarone R, for the ALTS Group. Comparison of three management strategies for patients with atypical squamous cells of undetermined significance: results from a randomized trial. J Natl Cancer Inst. 2001;93:293-299.
21. The ASCUS-LSIL Triage Study (ALTS) Group. Results of a randomized trial on the management of cytology interpretations of atypical squamous cells of undetermined significance. Am J Obstet Gynecol. 2003;188:1383-1392.
22. Manos MM, Kinney WK, Hurley LB, et al. Identifying women with cervical neoplasia. Using human papillomavirus DNA testing for equivocal Papanicolaou results. JAMA. 1999;281:1605-1610.
23. Wright TC Jr, Lorincz A, Ferris DG, et al. Reflex human papillomavirus deoxyribonucleic acid testing in women with abnormal Papanicolaou smears. Am J Obstet Gynecol. 1998;178:962-966.
24. Bergeron C, Jeannel D, Poveda JD, et al. Human papillomavirus testing in women with mild cytologic atypia. Obstet Gynecol. 2000;95:821-827.
25. Schiffman M, Adrianza ME, for the ALTS Group. ASCUS-LSIL triage study. Design, methods, and characteristics of trial participants. Acta Cytol. 2000;44:726-742.
26. Sherman ME, Schiffman M, Cox JT, for the Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesion Triage Study Group. Effects of age and human papilloma viral load on colposcopy triage: data from the randomized atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions triage study (ALTS). J Natl Cancer Inst. 2002;94:102-107.
27. Wright TC Jr, Schiffman M, Solomon D, et al. Interim guidance for the use of human papillomavirus DNA testing as an adjunct to cervical cytology for screening. Obstet Gynecol. 2004;103:304-309.
28. Ries LAG, Harkins D, Krapcho M, et al, eds. SEER Cancer Statistics Review, 1975-2003. National Cancer Institute: Bethesda, MD. Available at: http://seer.cancer.gov/csr/1975_2003/. Accessed March 18, 2007.
29. Schonberg MA, McCarthy EP, Davis RB, et al. Breast cancer screening in women aged 80 or older: results from a national survey. J Am Geriatr Soc. 2004;52:1688-1695.
30. Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285:2750-2756.
31. Goodwin JS, Samet JM, Key CR, et al. Stage at diagnosis of cancer varies with the age of the patient. J Am Geriatr Soc. 1986;34:20-26.
32. Holmes FF, Hearne E III. Cancer stage-to-age relationship: implications for cancer screening in the elderly. J Am Geriatr Soc. 1981;29:55-57.
33. Law TM, Hesketh PJ, Porter KA, et al. Breast cancer in elderly women: presentation, survival, and treatment options. Surg Clin North Am. 1006;76:289-308.
34. Satariano WA, Ragland DR. The effect of comorbidity on 3-year survival of women with primary breast cancer. Ann Intern Med. 1994;120:104-110.
35. Yancik R, Ries LG, Yates JW. Breast cancer in aging women: a population-based study of contrasts in stage, surgery, and survival. Cancer. 1989;63:976-981.
36. McCarthy EP, Burns RB, Freund KM, et al. Mammography use, breast cancer stage at diagnosis, and survival among older women. J Am Geriatr Soc. 2000;48:1226-1233.
37. Randolph WM, Goodwin JS, Mahnken JD, et al. Regular mammography use is associated with elimination of age-related disparities in size and stage of breast cancer at diagnosis. Ann Intern Med. 2002;137:783-790.
38. Allen C, Cox EB, Manton KG, et al. Breast cancer in the elderly. Current patterns of care. J Am Geriatr Soc. 1986;34:637-642.
39. Berg JW, Hutter RV. Breast cancer. Cancer. 1995;75:257-269.
40. Rosen PP, Lesser ML, Linne DW. Breast carcinomas at the extremes of age: a comparison of patients younger that 35 years and older than 75 years. J Surg Oncol. 1985;28:90-96.
41. Diab SG, Elledge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst. 2000;92:550-556.
42. Gajdos C, Tartter PI, Bleiweiss IJ, et al. The consequence of undertreating breast cancer in the elderly. J Am Coll Surg. 2001;192:698-707.
43. Messinger-Rapport BJ, Crowe JP. Breast surgery: minimally invasive diagnosis and treatment. Clin Geriatr Med. 2006;22:585-603.
44. Greenfield S, Blanco DM, Elashoff RM, et al. Patterns of care related to age of breast cancer patients. JAMA. 1987;257:2766-2770.
45. Silliman RA, Guadagnoli E, Weitberg AB, et al. Age as a predictor of diagnostic and initial treatment intensity in newly diagnosed breast cancer patients. J Gerentol. 1989;44:M46-M50.
46. Mohle-Boetani J. Age at breast cancer diagnosis as a predictor of subsequent survival. In: Macieira-Coelho A, Nordenskjold B, eds. Cancer and Aging. Boca Raton, FL: CRC Press; 1990:245-254.
47. Schwaibold F, Fowble BL, Solin LJ, et al. The results of radiation therapy for isolated local regional recurrence after mastectomy. Int J Radiat Oncol Biol Phys. 1991;21:299-310.
48. Votron L, D'Hoore W, Swine C, et al. The opinion of general practitioners on the treatment of prostate and breast cancer in elderly people: results of a survey based on clinical models. Clin Oncol (R Coll Radiol). 2004;16:474-478.
49. Bouchardy C, Rapiti E, Fioretta G, et al. Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol. 2003;21:3580-3587.
50. Bergman L, Kluck HM, van Leeuwen FE, et al. The influence of age on treatment choice and survival of elderly breast cancer patients in South-Eastern Netherlands: a population-based study. Eur J Cancer. 1992;28A:1475-1480.
51. DeMichele A, Putt M, Zhang Y, et al. Older age predicts a decline in adjuvant chemotherapy recommendations for patients with breast carcinoma: evidence from a tertiary care cohort of chemotherapy-eligible patients. Cancer. 2003;97:2150-2159.
52. Wanebo HJ, Cole B, Chung M, et al. Is surgical management compromised in elderly patients with breast cancer? Ann Surg. 1997;225:579-586.
53. Wazer DE, Erban JK, Robert NJ, et al. Breast conservation in elderly women for clinically negative axillary lymph nodes without axillary dissection. Cancer. 1994;74:878-883.
54. Lindsey AM, Larson PJ, Dodd MJ, et al. Comorbidity, nutritional intake, social support, weight, and functional status over time in older cancer patients receiving radiotherapy. Cancer Nurs. 1994;17:113-124.
55. Wyckoff J, Greenberg H, Sanderson R, et al. Breast irradiation in the older woman: a toxicity study. J Am Geriatr Soc. 1994;42:150-152.
56. Smith BD, Gross CP, Smith GL, et al. Effectiveness of radiation therapy for older women with early breast cancer. J Natl Cancer Inst. 2006;98:681-690.
57. Nemoto T, Patel JK, Rosner D, et al. Factors affecting recurrence in lumpectomy without irradiation for breast cancer. Cancer. 1991;67:2079-2082.
58. Schnitt SJ, Hayman J, Gelman R, et al. A retrospective study of conservative surgery alone in the treatment of selected patients with stage I breast cancer. Cancer. 1996;77:1094-1100.
59. Passage KJ, McCarthy NJ. Critical review of the management of early-stage breast cancer in elderly women. Intern Med J. 2007;37:181-189.
60. Hind D, Wyld L, Reed MW. Surgery, with or without tamoxifen, vs tamoxifen alone for older women with operable breast cancer: Cochrane review. Br J Cancer. 2007. [Epub ahead of print].
61. Hind D, Wyld L, Beverly CB, et al. Surgery versus primary endocrine therapy for operable breast cancer in elderly women (70 years plus). Cochrane Database Syst Rev. 2006:CD004272.
62. Gibson LJ, Dawson CL, Lawrence DJ, et al. Aromatase inhibitors for treatment of advanced breast cancer in postmenopausal women. Cochrane Database Syst Rev. 2007:CD003370.
63. Mandelblatt J, Saha S, Teutsch S, et al.; Cost Work Group of the US Preventive Services Task Force. The cost-effectiveness of screening mammography beyond age 65 years: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2003;139:835-842.
64. Mandelblatt JS, Schechter CB, Yabroff KR, et al, Breast Cancer in Older Women Research Consortium. Toward optimal screening strategies for older women. Costs, benefits, and harms of breast cancer screening by age, biology, and health status. J Gen Intern Med. 2005;20:487-496.
65. Chiarelli AM, Kirsh VA, Klar NS, et al. Influence of patterns of hormone replacement therapy use and mammographic density on breast cancer detection. Cancer Epidemiol Biomarkers Prev. 2006;15:1856-1862.
66. Persson I, Thurfjell E, Holmberg L. Effect of estrogen and estrogen-progestin replacement regimens on mammographic breast parenchymal density. J Clin Oncol. 1997;15:3201-3207.
67. Laya MB, Larson EB, Taplin SH, et al. Effect of estrogen replacement therapy on the specificity and sensitivity of screening mammography. J Natl Cancer Inst. 1996;88:627-628.
68. Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2006. CA Cancer J Clin. 2006;56:11-25.
69. US Preventive Services Task Force (USPSTF). Screening for breast cancer: recommendations and rationale. Released February 2002. Available at: http://www.ahrq.gov/clinic/uspstf.uspsbrca.htm. Accessed March 18, 2007.
70. American Medical Association. Report 16 of the Council of Scientific Affairs (A-99). Mammographic screening for asymptomatic women. June 1999. Available at: http://www.ama-assn.org/ama/pub/category/13541.html. Accessed March 18, 2007.
71. American College of Radiology (ACR). Practice guideline for the performance of screening mammography. Effective 10/1/2004. Available at: http://www.acr.org/s_acr/bin.asp?CID=549&DID=12281&DOC=FILE.PDF. Accessed March 18, 2007.
72. American College of Obstetricians and Gynecologists. Breast Cancer Screening. ACOG Practice Bulletin Number 42. Washington, DC: American College of Obstetricians and Gynecologists; 2003.
73. American Academy of Family Physicians. Recommendations for Clinical Preventive Services. Breast cancer. Available at: http://www.aafp.org/online/en/ home/clinical/exam/a-e.html. Accessed March 18, 2007.
74. Ferrini R, Mannino E, Ramsdell E, et al. Screening mammography for breast cancer: American College of Preventive Medicine practice policy statement. Am J Prev Med. 1996;12:340-341.
75. Saslow D, Boetes C, Burke W, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75-89.
76. Galit W, Green MS, Lital KB. Routine screening mammography in women older than 74 years: a review of the available data. Maturitas. 2007. [Epub ahead of print].
77. Morrow M. Breast disease in elderly women. Surg Clin North Am. 1994;74:145-161.
78. Thor AD, Way J, Barton SA. The breast. In: Rubin E, Gorstein F, Rubin R, et al, eds. Rubin's Pathology: Clinicopathologic Foundation of Medicine. 4th ed. Baltimore, MD: Lippincott Williams and Wilkins; 2005:997-1016.
79. Lester SC. The breast. In: Kumar V, Abbas AK, Fausto N, eds. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia, PA: Elsevier; 2005:1119-1132.
80. Kramer WM, Rush BF Jr. Mammary duct proliferation in the elderly: a histopathologic study. Cancer. 1973;31:130-137.
81. Bailey CL, Ueland FR, Land GL, et al. The malignant potential of small cystic ovarian tumors in women over 50 years of age. Gynecol Oncol. 1998;69:3-7.
82. Modesitt SC, Pavlik EJ, Ueland FR, et al. Risk of malignancy in unilocular ovarian cystic tumors less than 10 centimeters in diameter. Obstet Gynecol. 2003;102:594-599.
83. Wolf SI, Gosink BB, Feldesman MR, et al. Prevalence of simple adnexal cysts in postmenopausal women. Radiology. 1991;180:65-71.
84. Dorum A, Blom GP, Ekerhovd E, et al. Prevalence and histologic diagnosis of adnexal cysts in postmenopausal women: an autopsy study. Am J Obstet Gynecol. 2005;192:48-54.
85. Ueland FR, DePriest PD, Pavlik EJ, et al. Preoperative differentiation of malignant from benign ovarian tumors: the efficacy of morphology indexing and Doppler flow sonography. Gynecol Oncol. 2003;91:46-50.
86. Kurjak A, Zalud I, Alfirevic Z. Evaluation of adnexal masses with transvaginal color ultrasound. J Ultrasound Med. 1991;10:295-297.
87. Kurjak A, Kupesic S, Sparac V, et al. The detection of stage I ovarian cancer by three-dimensional sonography and power Doppler. Gynecol Oncol. 2003;90:258-264.
88. Tekay A, Jouppila P. Validity of pulsatility and resistance indices in classification of adnexal tumors with transvaginal color Doppler ultrasound. Ultrasound Obstet Gynecol. 1992;2:338-344.
89. Tekay A, Jouppila P. Controversies in assessment of ovarian tumors with transvaginal color Doppler ultrasound. Acta Obstet Gynecol Scand. 1996;75:316-329.
90. Alcazar JL, Castillo G. Comparison of 2-dimensional and 3-dimensional power-Doppler imaging in complex adnexal masses for the prediction of ovarian cancer. Am J Obstet Gynecol. 2005;192:807-812.
91. Jacobs I, Bast RC Jr. The CA 125 tumour-associated antigen: a review of the literature. Hum Reprod. 1989;4:1-12.
92. Malkasian GD Jr, Knapp RC, Lavin PT, et al. Preoperative evaluation of serum CA 125 levels in premenopausal and postmenopausal patients with pelvic masses: discrimination of benign from malignant disease. Am J Obstet Gynecol. 1988;159:341-346.
93. Skates SJ, Menon U, MacDonald N, et al. Calculation of the risk of ovarian cancer from serial CA-125 values for preclinical detection in postmenopausal women. J Clin Oncol. 2003;21(10 suppl):206-210.
94. van Nagell JR, DePriest PD. Management of adnexal masses in postmenopausal women. Am J Obstet Gynecol. 2005;193:30-35.
95. Bast RC Jr, Badgwell D, Lu Z, et al. New tumor markers: CA 125 and beyond. Int J Gynecol Cancer. 2005;15(suppl 3):274-281.
96. Petricoin EF, Ardekani AM, Hitt BA, et al. Use of proteomic patterns in serum to identify ovarian cancer. Lancet. 2002;359:572-577.
97. Ransohoff DF. Lessons from controversy: ovarian cancer screening and serum proteomics. J Natl Cancer Inst. 2005;97:315-319.
98. Earle CC, Schrag D, Neville BA, et al. Effect of surgeon specialty on processes of care and outcomes for ovarian cancer patients. J Natl Cancer Inst. 2006;98:151-154.
99. Engelen MJ, Kos HE, Willemse PH, et al. Surgery by consultant gynecologic oncologists improves survival in patients with ovarian carcinoma. Cancer. 2006;106:589-598.
100. Carney ME, Lancaster JM, Ford C, et al. A population-based study of patterns of care for ovarian cancer: who is seen by a gynecologic oncologist and who is not? Gynecol Oncol. 2002;84:36-42.
101. Eisenkop SM, Spirtos NM, Montag TW, et al. The impact of subspecialty training on the management of advanced ovarian cancer. Gynecol Oncol. 1992;47:203-209.
102. Ozalp S, Tanir HM, Gurer H. Gynecologic problems among elderly women in comparison with women aged between 45-64 years. Eur J Gynaecol Oncol. 2006;27:179-181.
103. Lidor A, Ismajovish B, Confino R, et al. Histopathological findings in 226 women with post-menopausal uterine bleeding. Acta Obstet Gynecol Scand. 1986;65:41-43.
104. Dijkhuizen FP, Mol BW, Brolmann HA, et al. The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer. 2000;89:1765-1772.
105. Smith-Bindman R, Kerlikowske K, Feldstein VA, et al. Endovaginal ultrasound to exclude endometrial cancer and other endometrial abnormalities. JAMA. 1998;280:1510-1517.
106. Tabor A, Watt HC, Wald NJ. Endometrial thickness as a test for endometrial cancer in women with postmenopausal bleeding. Obstet Gynecol. 2002;99:663-670.
107. Ceci O, Bettochi S, Pellegrino A, et al. Comparison of hysteroscopic and hysterectomy findings for assessing the diagnostic accuracy of office hysteroscopy. Fertil Steril. 2002;78:628-631.
108. DiSaia PJ, Creasman WT. Adenocarcinoma of the uterus. In: DiSaia PJ, Creasman WT, eds. Clincal Gynecologic Oncology. 5th ed. St Louis: Mosby; 1997:143-144.
109. Wang J, Wieslander C, Hansen G, et al. Thin endometrial echo complex on ultrasound does not reliably exclude type 2 endometrial cancers. Gynecol Oncol. 2006;101:120-125.
110. Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients. Cancer. 1985;56:403-412.
111. Ferenczy A, Gelfand M. The biologic significance of cytologic atypia in progestogen-treated endometrial hyperplasia. Am J Obstet Gynecol. 1989;160:126-131.
112. Baak JP, Mutter GL, Robboy S, et al. The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately that the 1994 World Health Organization classification system. Cancer. 2005;103:2304-2312.
113. Kurman RJ, Norris HJ. Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well-differentiated carcinoma. Cancer. 1982;49:2547-2559.
114. Trimble CL, Kauderer J, Zaino R, et al. Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer. 2006;106:812-819.
115. Kendall BS, Ronnett BM, Isacson C, et al. Reproducibility of the diagnosis of endometrial hyperplasia, atypical hyperplasia, and well-differentiated carcinoma. Am J Surg Pathol. 1998;22:1012-1019.
116. Bergeron C, Nogales FF, Masseroli M, et al. A multicentric European study testing the reproducibility of the WHO classification of endometrial hyperplasia with a proposal of a simplified working classification for biopsy and curettage specimens. Am J Surg Pathol. 1999;23:1102-1108.
117. Zaino RJ, Kauderer J, Trimble CL, et al. Reproducibility of the diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer. 2006;106:804-811.
118. www.endometrium.org. Website maintained by George L. Mutter, MD; of the Division of Women's and Perinatal Pathology at Brigham and Women's Hospital, Boston, MA. Accessed April 20, 2007.
119. Dunton CJ, Baak JP, Palazzo JP, et al. Use of computerized morphometric analyses of endometrial hyperplasias in the prediction of coexistent cancer. Am J Obstet gynecol. 1996;174:1518-1521.
120. Baak JP, Orbo A, van Diest PJ, et al. Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias. Am J Surg Pathol. 2001;25:930-935.
121. DiSaia PJ, Creasman WT. Endometrial hyperplasia/estrogen therapy. In: DiSaia PJ, Creasman WT, eds. Clincal Gynecologic Oncology. 5th ed. St Louis: Mosby; 1997:112-114.
122. Jobo T, Kawaguchi M, Imai M, et al. Treatment for complex atypical hyperplasia of the endometrium. Eur J Gynaecol Oncol. 2001;22:365-368.
123. Randall TC, Kurman RJ. Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40. Obstet Gynecol. 1997;90:434-440.
124. Wildermeersch D, Janssens D, Pylyser K, et al. Management of patients with non-atypical and atypical endometrial hyperplasia with a levonorgestrel-releasing intrauterine system: long-term follow-up. Maturitas. 2007. [Epub ahead of print].
125. Vereide AB, Kaino T, Sager G, et al. Effect of levonorgestrel IUD and oral medroxyprogesterone acetate on glandular and stromal progesterone receptors (PRA and PRB), and estrogen receptors (ER-alpha and ER-beta) in human endometrial hyperplasia. Gynecol Oncol. 2006;101:214-223.
126. Agorastos T, Vaitsi V, Pantazis K, et al. Aromatase inhibitor anastrozole for treating endometrial hyperplasia in obese postmenopausal women. Eur J Obstet Gynecol Reprod Biol. 2005;118:239-240.
127. Lowe MP, Cooper BC, Sood AK, et al. Implementation of assisted reproductive technologies following conservative management of FIGO grade I endometrial adenocarcinoma and/or complex hyperplasia with atypia. Gynecol Oncol. 2003;91:569-572.
128. Ramirez PT, Frumovotz M, Bodurka DC, et al. Hormonal therapy for the management of grade 1 endometrial adenocarcinoma: a literature review. Gynecol Oncol. 2004;95:133-138.
129. Lelle RJ, Morley GW, Peters WA. The role of vaginal hysterectomy in the treatment of endometrial carcinoma. Int J Gynecol Cancer. 1994;4:342-347.
130. Bloss JD, Berman ML, Bloss LP, et al. Use of vaginal hysterectomy for the management of stage I endometrial cancer in the medically compromised patient. Gynecol Oncol. 1991;40:74-77.
131. Chan JK, Lin YG, Monk BJ, et al. Vaginal hysterectomy as primary treatment of endometrial cancer in medically compromised women. Obstet Gynecol. 2001;97:707-711.