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 postmenopausal ovarian tumor  

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hi guys
which is the best screening test in postmenopausal women for ovarian tumors?


b-bimanual palpation.
explain with reason. :?: :|



a. I don't know why "a" but I know why not "b".To be palpated by bimanual pelvic exam ovarian ca had to be pretty large (advance ), so that is not good for screening.And I guess tumer marker ca125 can be detected at an earlier stage,so a better screening test.


bimanual examination
bcoz ovaries in postmenopaual female shud be atrophic but if its palpable===> tm

sx appears late but ovaries bcome palpable...


hi mash
ithought the answer should be bimanual too.but in UW its given as CA 125.thats y i posted it here.



acc to kaplan its bimanual pelvic examn
acc to bp., ca 125 is used to follow up treatment but cant be used fr screening becoz its +ve in a lot benign and malignant conditions of ovaries and other organs...
Conditions in which CA-125 levels may be elevated

Pelvic inflammatory disease
Uterine fibroids
Liver cirrhosis

Tumors of the:



thanks mash grin u are gonna ace the test <:better_now:> :icon_salut: :icon_thumb:


mash good explaination.But last night I went through similar q in uw.It was for a 55y/o pt with FHx of ovarian ca and the answer was CA125.Bimanual Pelv exam was also an option and it says that the tumor wud be too advanced to be picked up by pelvic exam.Now which one shud we follow :icon_scratch: .confusing ,isn't it?


almost all of uw ans are correct but if u ve any doubts , u can email them and ask fr clarification..
i think this one is confusing bcoz neither ca 125 nor bimanual pelvic examn nor transvaginal USG ve been found to be good fr screening..

'An NIH consensus panel recommends family history and annual pelvic examination for ovarian cancer screening. The American Cancer Society, National Cancer Institute, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American Medical Association, American Nurse's Association, and American Medical Women's Association recommend annual pelvic exams (along with Pap smears) for women starting when sexual activity commences or age 18. The US Preventive Services Task Force does not recommend routine pelvic examination for the detection of ovarian cancer. No organization currently recommends either ultrasound or cancer marker screening in asymptomatic women, and multiple organizations (including the American College of Physicians, the Canadian Task Force on the Periodic Health Examination, and the American College of Obstetricians and Gynecologists) recommend against it. Regarding women at higher risk (e.g., hereditary cancer syndromes), the NIH consensus conference recommends annual CA 125 measurements, pelvic exam, and transvaginal ultrasound until childbearing is completed; at age 35, women should be referred for bilateral oophorectomy. The US Preventive Services Task Force and Canadian Task Force on the Periodic Health Examination find insufficient evidence to define or screen high-risk women, although the U.S. Task Force suggests specialist referral for women with hereditary cancer syndromes.'


hamidi,i think if woman is high risk(family hx +) then CA 125 is better , otherwise in asymptomatic pt , bimanual pelvic examn wud be the ans..


Thanks mash, :lol: U r great.



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