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Morcellation of Uterine Fibroids Creates Cancer Risk

Photo of Armand Leone

Using a power morcellation tool to remove uterine fibroids creates an unnecessary risk of spreading uterine cancer throughout the body, causing some women to rapidly develop advanced cancer. There is no reliable method for predicting whether a woman with fibroids may have a uterine sarcoma. When a power morcellator is used to break uterine fibroid tissue into small pieces for easy removal, any cancer cells within the tissue can become detached from the underlying mass and circulate through the bloodstream causing hematogenous spread of cancer throughout the body. The FDA discouraged the use of laparoscopic power morcellation during hysterectomy or myomectomy for uterine fibroids earlier this year and Ethicon, a Johnson & Johnson company, finally issued a global recall of all power morcellators on Wednesday July 30, 2014.

Uterine carcinoma can occur in a fibroid uterus, and treatment for fibroids must recognize the need for pathological examination to make certain that the removed fibroid was benign and without any malignancy. Initially, uterine carcinoma spreads by local extension, by traveling into the fallopian tubes, by invading the lymphatic system and ultimately by spreading through the blood stream. Morcellation has the potential to increase the risk and speed of spread through the fallopian tubes and the blood, causing the disease to advance rapidly. While most fibroids do not contain cancer, uterine fibroids are such a common disease that a significant number of women who undergo power morcellation treatment are at risk of accelerated cancer spread.

Britcher Leone & Roth, LLC recognizes that even though the risk of accelerated cancer dissemination from morcellation is relatively small, women who do have an underlying uterine cancer and undergo the procedure have to be concerned about developing advanced cancer. The specific facts of each case need to be looked at to see if a morcellation procedure was the likely cause of the spread of a uterine cancer. Patients who have undergone morcellation therapy for fibroids and subsequently were diagnosed with uterine cancer should inquire as to whether or not the morcellation procedure was a substantial factor in its spread.

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