Ovarian swellings and screening for ovarian cancer

Ovarian cysts are very common.  During reproductive years each month a small cyst ('follicle') develops in the ovaries, reaches approximately one inch in size and then breaks up in the mid-cycle to release an egg.  Sometimes, instead of breaking up, the cyst may grow large and cause a noticeable swelling and pain. These ‘functional cysts’ are the most common cysts found in the ovaries.  Apart from functional cysts the ovaries may contain other benign ovarian cysts, which can occur both before and after menopause.  Large benign cysts, which are causing symptoms, may need to be surgically removed.  Many small benign cysts; however, are detected incidentally on MRI or CT scans performed to investigate various non-gynaecological problems.  In such cases the presence of the cyst sometimes causes concern if there is uncertainly about their nature. Cancerous cysts are very rare, but they can cause serious health problems and they should be removed as soon as the diagnosis is established with certainty.

An accurate diagnosis of the exact nature of an ovarian cyst is important for planning appropriate treatment. Benign cysts, which cause no symptoms, may not require any treatment, whilst those causing pain could be removed using key-hole surgery. Cancerous cysts often require major open surgery.

The ability of ultrasound examination to discriminate between different types of ovarian cysts mainly depends of the skill and experience of the examiner. Consultants in our centre have been in the forefront of developments in ultrasound diagnosis of ovarian cancer for many years and they are able to differentiate between benign and malignant ovarian cysts in most cases by performing a systematic and detailed analysis of the cyst appearance.  Our approach to the diagnosis of ovarian cysts does not require a blood test to measure tumour markers, which avoids delays in reaching the correct diagnosis and reduces the overall cost on investigations.

Some women with a family history of ovarian or breast cancer are at increased risk of developing ovarian cancer themselves.  We are able to provide them with regular scans to reassure them that their ovaries are normal. We also see women who suffered ovarian or breast cancer in the past and who are at increased risk of developing ovarian cancer.

Ovarian swellings