1.7 Surveillance of the endometrium by gynaecological examination, transvaginal IV B 97.3% (36) yes, 2.7% ultrasound and aspiration biopsy starting from the age of 35 years (annually (1) abstain (37 voters) until hysterectomy) should be offered to all LS mutation carriers 1.8 Prophylactic surgery (hysterectomy and bilateral salpingo-oophorectomy), IV B 100% yes (37 voters) preferably using a minimally invasive approach, should be discussed at the age of 40 as an option for LS mutation carriers to prevent endometrial and ovarian cancer. All pros and cons of prophylactic surgery must be discussed 2. What work-up and management scheme should be undertaken for therapy in patients with AH/EIN and grade 1 EEC? Recommendations: 2.1 Patients with AH/EIN or grade 1 EEC requesting fertility-preserving therapy V A 100% yes (37 voters) must be referred to specialised centres 2.2 In these patients, D&C with or without hysteroscopy must be performed IV A 97.3% (36) yes, 2.7% (1) abstain (37 voters) 2.3 AH/EIN or grade 1 EEC must be confirmed/diagnosed by a specialist IV A 100% yes (37 voters) gynecopathologist 2.4 Pelvic MRI should be performed to exclude myometrial invasion and III B 100% yes (37 voters) adnexal involvement. Expert ultrasound can be considered as an alternative
1.7 Surveillance of the endometrium by gynaecological examination, transvaginal ultrasound and aspiration biopsy starting from the age of 35 years (annually until hysterectomy) should be offered to all LS mutation carriers IV B 97.3% (36) yes, 2.7% (1) abstain (37 voters) 1.8 Prophylactic surgery (hysterectomy and bilateral salpingo-oophorectomy), preferably using a minimally invasive approach, should be discussed at the age of 40 as an option for LS mutation carriers to prevent endometrial and ovarian cancer. All pros and cons of prophylactic surgery must be discussed IV B 100% yes (37 voters) 2. What work-up and management scheme should be undertaken for therapy in patients with AH/EIN and grade 1 EEC? Recommendations: 2.1 Patients with AH/EIN or grade 1 EEC requesting fertility-preserving therapy must be referred to specialised centres V A 100% yes (37 voters) 2.2 In these patients, D&C with or without hysteroscopy must be performed IV A 97.3% (36) yes, 2.7% (1) abstain (37 voters) 2.3 AH/EIN or grade 1 EEC must be confirmed/diagnosed by a specialist gynecopathologist IV A 100% yes (37 voters) 2.4 Pelvic MRI should be performed to exclude myometrial invasion and adnexal involvement. Expert ultrasound can be considered as an alternative III B 100% yes (37 voters)