Complex ovarian cyst & thickened endrometrium - postmenopausal

Not overreacting! I understand your concern! I’m 71, 3 years post BC surgery, on tamoxifen, and seeing a gynecologist annually to watch for uterine cancer. Uterine thickening and fibroids can be a benign result, from what I’ve read. I would expect them to do follow-up testing for a complex uterine cyst. I’d ask for a pelvic MRI.

Here’s my checklist of things to do/watch for:
-Genetic testing*
-HPV test, often done along with a Pap smear
-Blood markers for uterine specific cancer**
-Changes over time in results of transvaginal US
-Pelvic MRI
-Go to a comprehensive cancer center to get an expert review of your current cancer risk*** These centers often prioritize scans, like MRI, for diagnosis
-Prior HRT, of some drug types, or breast cancer hormone therapy can increase risk, include details in health history
-If high risk, ask about a salpingectomy, removal of the fallopean tubes is least invasive and may reduce risk without removing ovaries****

*Invitae, a genetic testing site, has been used by Mayo Clinic, MD Anderson and Memorial Sloan Kettering from patient report. I only paid a small co-pay for the blood draw, genetic testing was paid by insurance. They also have a discounted direct pay option, details on their site. https://www.invitae.com/us/providers/test-catalog/test-01201

** Blood markers https://pmc.ncbi.nlm.nih.gov/articles/PMC10455076/

*** There is a misconception that a referral is required to go to a cancer center. Not true. You can “self refer”. I did at MD Anderson because they were the closest to me. On the Mayo Clinic site, you can request an appointment. I’d follow it up with a phone call if the appt options are too far in the future.
https://www.mayoclinic.org/departments-centers/mayo-clinic-cancer-center/cancer-care/appointments
**** Salpingectomy https://my.clevelandclinic.org/health/treatments/21879-salpingectomy

@maryk2025 Welcome to Mayo Clinic Connect. I see you've already received great support and suggestions from Ruby Slippers @triciaot. I want to also say that you are not overreacting at all! You've had breast cancer and I'm thinking that diagnosis was a shock to you. I imagine that hearing the word "cancer" again would be awful.

I was diagnosed with endometrial cancer (endometrioid adenocarcinoma, FIGO Grade 1) in 2019. I was referred to Mayo Clinic where I had a radical hysterectomy and learned that the cancer was staged by pathology at 1a. No adjuvant treatment was recommended at that. time. Two years later in 2021 I was diagnosed with a recurrence. Hearing the word "cancer" again just two years later was almost as frightening as the first time I heard it. For the recurrence I had 25 external beam pelvic radiation and 2 brachytherapy sessions. I've kept up on all of my follow-up appointments and have been NED (no evidence of disease) since 2021.

I agree with could be worthwhile to get another opinion at a comprehensive cancer center. You may decide ou want to do this after meeting with your oncologist in October. Are you located in the U.S.? Mayo Clinic is one of these cancer centers as is MD Anderson.

Find a National Cancer Institute-Designated Cancer Center:

-- https://www.cancer.gov/research/infrastructure/cancer-centers/find

How do you feel after some reassurance from us?

Thank you so much for this information. It really helps. I have decided to move forward and request the biopsy with my current gyno just to put my mind at rest and know what next steps are. I still have a 2nd opinion set up for December but would rather know what I am dealing with than letting my mind leap to worse case scenarios. Haven't been able to sleep and that just makes the worry worse. Thank you so for your suggestions and will definitely move forward with those once I know what the biopsy and ultrasound results are. Thank you again and please take care.

I’ll say a prayer for you.
Philippians 4:6-7

Hi, another option to consider is a D&C procedure. I believe this can help reduce the endometrial lining. However, I'm not certain if it will address the polyp on the cervix. Additionally, you might want to inquire about the option of a hysterectomy if you are considering surgery. Best of luck!

@maryk2025 That sounds like a good plan.

If I understand correctly your appointment with your gynecologist is in December, is that right? If so, that's a long time to wait. I suggest that you call your gynecologist's office and ask to be placed on a wait list that allows you to be called if an earlier appointment becomes available. If this were me or a close friend or relative and I didn't hear back on an earlier appointment I would call once a week and ask. You are your own best advocate. I know it can feel somewhat difficult to do this but my experience and that of many others here on Mayo Clinic Connect is that this works to get an earlier appointment.

What do you think about my suggestion?

That is a good idea - thank you - I will definitely try that