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abstract
Data from screening trials indicate that a significant
percent of asymptomatic women older than 50 years of age will develop
ovarian abnormalities that are detectable by ultrasonography. Most of
these abnormalities are benign, and many will resolve spontaneously.
However, the risk of ovarian cancer, particularly in postmenopausal
women, is of concern. The goal is to use a diagnostic and treatment
algorithm that will reliably detect ovarian cancer at the earliest
possible stage while limiting the number of women undergoing surgery for
benign disease. The combination of morphology indexing and serum
biomarker analysis can accurately predict the risk of malignancy in most
ovarian tumors. Ovarian tumors with cystic or septate morphology are at
minimal risk of malignancy and can be followed with serial
ultrasonography evaluations, thereby avoiding the morbidity and cost of
surgery. Complex or solid ovarian tumors with a high morphology index
score, or those with increasing biomarker production, are at a high risk
of malignancy, and patients with these tumors should be referred to a
gynecologic oncologist for further evaluation and treatment.
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