© 2007 General Hospital Corporation j.jacr.2007.07.006
Janet C. Miller, DPhil, Neil S. Horowitz, MD, James H. Thrall, MD, and Susanna I. Lee, MD, PhD
Ovarian cancer is the leading cause of death from gynecologic cancers, with 22,480 estimated new cases and 15,280 deaths in 2007 [1]. If diagnosed at stage I, there is a greater than 90% survival rate at 5 years, but if diagnosed at stage III or IV, as are 65% to 70% of cases, the 5-year survival rate is 30% to 55%. Being diagnosed with an adnexal mass is a very common clinical dilemma for women in the United States, with a 5% to 10% lifetime risk for undergoing surgery for this indication. Although the majority of these masses are benign [2], the goal of the diagnostic evaluation is to exclude any possibility of malignancy. Screening programs, undertaken with the hope of detecting ovarian cancer at an early stage, have provided valuable insight into the incidence of adnexal masses, their natural history, and strategies for their management.