At the Women's Health Group, we continue to strive to give our patients the most comprehensive care available and continue to stay abreast to the continuing changes and advances in women's health care.
We are aware of the recent controversy regarding the use of a mechanical morcellator as part of the process of removing large fibroid tumors during laparoscopic hysterectomy and myomectomy. The possibility of inadvertent intrabdominal spread of an occult or hidden cancer is something we take very seriously. We wish to emphasize that the possibility that a fibroid uterus contains cancerous, muscle tumor cells is very remote and that the current literature suggests that less than 1 in a thousand cases (or 3 in 10,000) of fibroids contains cancer. As with the most common type of uterine cancer, endometrial, this type of cancer cannot be screened for prior to surgery. Therefore, most, if not all, leiomyosacrcomas are discovered at time of pathological review, after the hysterectomy has been completed. Although the potential of finding cancer after morcellation is there, the likelihood of this occurring is very rare and after over 20 years of experience in our practice, we have never run into a case where cancer of uterine fibroids was morcellated and caused harm to a patient.
Based on the surgical advantage there is to morcellate large uteri (smaller incisions, quicker recovery, increased patient satisfaction), we still promote the use of the mechanical morcellator and attest to its safety and effectiveness. We continue to screen our patients for increased risks of leiomyosarcomas based on age, ethnicity and history of Tomaxifen use. If you ever have questions or concerns about the use of morcellation, please discuss with your provider and we will gladly review all available data with you to provide the most tailored care for your condition.