From the Guidelines
Fibroids themselves are not cancerous and do not increase the chance of developing uterine cancer, but certain symptoms like rapid fibroid growth, especially after menopause, or growth of fibroids during hormone therapy should prompt medical evaluation as these could potentially indicate malignancy. Uterine fibroids are benign (non-cancerous) growths of muscle tissue in the uterus that occur in about 70-80% of women by age 50 1. The risk of a fibroid turning into cancer (leiomyosarcoma) is extremely rare, estimated at less than 1 in 1,000 cases.
Key Points to Consider
- The natural history of fibroids is shrinkage and symptom resolution with menopause due to decreased circulating estrogen and the cessation of menses 1.
- Suspicion for malignancy should be increased in postmenopausal patients with fibroids and persistent abnormal uterine bleeding, fibroid growth, or both 1.
- It is essential to pursue endometrial biopsy prior to intervention because it can rule out endometrial neoplasia and, in some cases, diagnose sarcoma 1.
- Having fibroids does not increase your risk of developing other gynecological cancers either, as supported by older studies 1.
- Regular gynecological check-ups are recommended for women with fibroids to monitor any changes, and if you experience sudden changes in symptoms such as abnormal bleeding, increasing pelvic pain, or rapid growth in the size of your abdomen, you should consult your healthcare provider promptly for evaluation.
Symptoms to Watch For
- Rapid fibroid growth, especially after menopause
- Growth of fibroids during hormone therapy
- Abnormal uterine bleeding
- Increasing pelvic pain
- Rapid growth in the size of your abdomen
Given the most recent evidence from 2024 1, it's clear that while fibroids themselves are not cancerous, certain symptoms and patient profiles warrant closer monitoring and potentially further investigation to rule out malignancy.
From the Research
Uterine Leiomyomas and Malignancy Risk
- Uterine fibroids (leiomyomas) are benign tumors that are common in women, but the question remains whether they increase the risk of malignancy 2.
- Studies have shown that leiomyosarcomas, a type of uterine cancer, may not arise from malignant changes in fibroids 2.
- A population-based study found no evidence of a higher risk of uterine malignancy in women with uterine fibroids confirmed by myomectomy 2.
- The study compared the incidence of uterine cancer in women with uterine fibroids to a control group and found no significant difference in the risk of uterine malignancy 2.
Treatment and Management of Uterine Fibroids
- Treatment options for uterine fibroids include surgical interventions, such as hysterectomy and myomectomy, as well as medical treatments, such as gonadotropin-releasing hormone (GnRH) analogues 3, 4.
- Minimally invasive techniques, such as uterine artery embolization and radiofrequency ablation, are also available for the treatment of uterine fibroids 3, 5.
- The choice of treatment depends on the patient's age, fertility, and the number, size, and location of the fibroids 3.
Diagnosis and Classification of Uterine Fibroids
- Magnetic resonance imaging (MRI) is considered the best modality for diagnosing and characterizing uterine fibroids 6.
- The FIGO classification system is used to describe and classify fibroid locations in a systematic and consistent manner 6.
- Accurate diagnosis and classification of uterine fibroids are important for determining the best course of treatment 6.