Our Summary

This research paper is all about studying the effectiveness of a procedure called Ovarian Needle Aspiration and Biopsy (ONAB), which is used to diagnose ovarian cancer or assist in the removal of ovarian masses. Some doctors hesitate to use this procedure because it can potentially rupture the cyst or spread cancerous cells.

To study the usefulness of this procedure, the researchers looked at all the ONAB samples from the Queen’s Medical Center Pathology Department between 2000 and 2013. They reviewed these samples and compared them with what they found in the patients’ medical histories.

The study found 144 cases where ONAB was used. Of these, 92 cases had matching medical history, and in 84 of these, the ONAB was done at the same time. Out of these 92 cases, they found that 12 were cancerous and 80 were not. There were three cases where the ONAB didn’t find cancer that was actually there - these were due to errors in taking the sample, not because the procedure itself failed.

The research concluded that ONAB was able to accurately detect ovarian cancer in 75% of cases and was 100% accurate in confirming when cancer was not present. The procedure was also 100% accurate in predicting when cancer would be found later, and 96% accurate in predicting when it would not.

So, the researchers concluded that ONAB is a useful tool in diagnosing and treating ovarian masses. In this study, it was very specific and had excellent predictive value.

FAQs

  1. What is the purpose of Ovarian Needle Aspiration and Biopsy (ONAB)?
  2. What is the sensitivity and specificity of ONAB in detecting ovarian malignancies?
  3. Were there any false negative cases in the study and if so, what were they?

Doctor’s Tip

A helpful tip a doctor might tell a patient about ovarian cyst removal is to discuss the option of ovarian needle aspiration and biopsy (ONAB) with their healthcare provider. This procedure can help in the diagnosis of ovarian malignancies and facilitate the removal of ovarian masses. It is important to understand that ONAB has shown to be highly specific in detecting malignancy, with excellent positive and negative predictive values. By discussing this option with their doctor, patients can make informed decisions about their treatment plan.

Suitable For

Patients who are typically recommended for ovarian cyst removal include those with:

  1. Symptomatic cysts: Patients experiencing symptoms such as pelvic pain, bloating, abdominal discomfort, or irregular menstrual cycles may be recommended for ovarian cyst removal to alleviate these symptoms.

  2. Large cysts: Cysts that are larger in size, typically over 5 centimeters, may be recommended for removal due to the risk of complications such as rupture or torsion.

  3. Complex cysts: Cysts that are complex in nature, with solid components or septations, may be recommended for removal to rule out the possibility of ovarian cancer.

  4. Cysts with suspicious features: Cysts that show concerning characteristics on imaging studies, such as rapid growth, irregular borders, or abnormal blood flow, may be recommended for removal to evaluate for malignancy.

  5. Recurrent cysts: Patients who have recurrent ovarian cysts may be recommended for removal to prevent future complications or to further investigate the underlying cause of the cysts.

Overall, the decision to recommend ovarian cyst removal is based on a thorough evaluation of the patient’s symptoms, imaging studies, and risk factors for ovarian cancer. It is important for patients to discuss the risks and benefits of ovarian cyst removal with their healthcare provider to make an informed decision about their treatment options.

Timeline

Before ovarian cyst removal:

  1. Patient experiences symptoms such as abdominal pain, bloating, and irregular menstrual cycles.
  2. Patient undergoes imaging tests such as ultrasound or MRI to diagnose the ovarian cyst.
  3. If the cyst is suspicious for malignancy, the patient may undergo ovarian needle aspiration and biopsy (ONAB) for further evaluation.
  4. ONAB is performed to obtain cytologic specimens for analysis to determine if the cyst is benign or malignant.
  5. Treatment options are discussed with the patient, including surgical removal of the cyst.

After ovarian cyst removal:

  1. Patient undergoes surgical removal of the ovarian cyst, either through laparoscopic or open surgery.
  2. The cyst is sent for histopathologic examination to confirm the diagnosis.
  3. Results of the biopsy are reviewed, and the patient is informed of the findings.
  4. If the cyst was malignant, further treatment options such as chemotherapy or radiation therapy may be recommended.
  5. Follow-up appointments are scheduled to monitor the patient’s recovery and ensure there is no recurrence of the cyst.

What to Ask Your Doctor

Some questions a patient should ask their doctor about ovarian cyst removal include:

  1. What are the risks and benefits of removing the ovarian cyst?
  2. What type of procedure will be used to remove the cyst (laparoscopic surgery, open surgery, etc.)?
  3. How long is the recovery time after the cyst removal surgery?
  4. Will removing the cyst affect my fertility or hormone levels?
  5. Are there any alternative treatments to removing the cyst?
  6. What are the chances of the cyst being cancerous?
  7. How will the pathology results from the cyst removal be communicated to me?
  8. What follow-up care will be needed after the cyst removal surgery?
  9. How often should I have follow-up appointments to monitor for any recurrence of the cyst?
  10. Are there any lifestyle changes or precautions I should take after the cyst removal surgery?

Reference

Authors: Nagamine K, Kondo J, Kaneshiro R, Tauchi-Nishi P, Terada K. Journal: J Gynecol Oncol. 2017 Jul;28(4):e40. doi: 10.3802/jgo.2017.28.e40. PMID: 28541632