Fibroids and Morcellation: What Patients Need to Know Before Surgery
What Every Patient Should Understand Before Uterine Surgery
If you have been told that you have uterine fibroids and surgery has been recommended, there is an important question to ask before the procedure:
How will the uterus or fibroid be removed from my body?
Most uterine fibroids are benign. But before surgery, doctors cannot reliably identify every uterine leiomyosarcoma, a rare cancer that can sometimes resemble a fibroid.
That uncertainty matters because some surgical techniques involve morcellation - cutting uterine tissue or a fibroid into smaller pieces so it can be removed through a smaller opening.
Morcellation can make minimally invasive surgery possible for some patients. Minimally invasive surgery can have meaningful benefits, including smaller incisions and faster recovery compared with some open procedures.
But if the tissue unexpectedly contains cancer, fragmenting it can spread malignant tissue within the abdomen and pelvis.
That is why the decision about morcellation is not simply a question of whether a surgery can be performed through small incisions.
It is a question of how the tissue will be removed, what is known about the mass before surgery, what risks apply to you, and what alternatives are available.
What Is Morcellation?
Morcellation means dividing tissue into smaller pieces so it can be removed through a smaller opening.
Morcellation may be performed manually or with a powered surgical device.
It can be used during procedures such as hysterectomy or myomectomy when the uterus or fibroid is too large to remove through the planned incision without reducing its size.
The important distinction for patients is not simply whether surgery is laparoscopic.
The important question is:
Will my uterus or fibroid be removed intact, or will it be cut into pieces?
A laparoscopic procedure does not automatically mean that morcellation will be used.
Depending on the circumstances, tissue may be removed intact through the vagina, through a larger abdominal opening, or by another surgical approach.
Why Does Morcellation Matter If the Fibroid Is Probably Benign?
Because “probably a fibroid” is not the same thing as “cancer has been ruled out.”
Uterine fibroids are extremely common.
Uterine leiomyosarcoma is rare.
Unfortunately, current medicine cannot reliably distinguish every leiomyosarcoma from a benign fibroid before surgery. A final diagnosis usually depends on examination of the removed tissue by a pathologist.
That creates a difficult situation.
A surgeon may reasonably believe that a patient has a benign fibroid and plan a minimally invasive operation.
But if the mass unexpectedly contains a leiomyosarcoma, cutting the tissue into pieces can potentially disseminate malignant tissue within the abdomen and pelvis.
The FDA specifically warns that laparoscopic power morcellation can spread unsuspected cancer and may worsen long-term survival.
This does not mean that every fibroid is suspicious.
It does not mean that every patient should have an open abdominal operation.
It means that the risks and alternatives should be discussed before surgery.
Fibroids and Uterine Leiomyosarcoma Are Not the Same Thing
A fibroid, also called a leiomyoma, is a common benign growth of the uterus.
A uterine leiomyosarcoma is a rare malignant tumor arising from smooth muscle.
A typical fibroid does not simply “turn into” leiomyosarcoma.
The problem is that the two can sometimes appear similar before surgery.
Imaging, symptoms, age, menopausal status, medical history, and other findings can help doctors assess risk.
But there is currently no preoperative test that can reliably rule out every uterine leiomyosarcoma.
That is why the surgical plan deserves careful consideration when a uterine mass is presumed to be a fibroid.
Are There Reasons to Be More Cautious About a Presumed Fibroid?
Most uterine masses are not uterine leiomyosarcoma.
That is important.
I do not want a woman reading this article to believe that having a fibroid means she has cancer.
But there are circumstances that may make a doctor more concerned about the possibility of an unexpected uterine sarcoma.
That matters because uLMS cannot be reliably ruled out before surgery in every patient.
When there are additional risk factors or concerning findings, I believe patients should have an especially clear conversation about how the mass will be removed and whether it will be cut into pieces.
The following factors do not mean that someone has uLMS.
They mean there may be additional reasons to discuss the diagnosis and surgical plan carefully.
Age and Postmenopausal Status
Age is one of the most important considerations.
Uterine leiomyosarcoma is more commonly diagnosed in older women, and the incidence increases substantially after age 50.
A consensus statement on evaluating uterine masses reports that women over 50 have a substantially higher incidence of uterine sarcoma than younger women. It also identifies postmenopausal status as an important risk factor.
The FDA specifically recommends against laparoscopic power morcellation for presumed fibroids in postmenopausal women or women over 50.
That does not mean every woman over 50 has a dangerous fibroid.
It means age should be part of the conversation.
If you are postmenopausal or over 50 and have a uterine mass that is being treated as a fibroid, ask:
“How confident are we that this is a benign fibroid, and how will the mass be removed?”
Black Women May Have a Higher Risk of Uterine Leiomyosarcoma
Race is another factor that deserves attention.
Research has found that Black women have a higher incidence of uterine leiomyosarcoma than White women. A published consensus statement on MRI evaluation of uterine masses reports approximately a twofold higher incidence of uLMS among Black women compared with White women.
This is different from saying that Black women are more likely to have cancer every time they develop a fibroid.
Fibroids themselves are also substantially more common in Black women. Studies have found that uterine fibroids occur approximately two to three times more often in Black women than in White women.
That makes this distinction especially important.
A Black woman with a uterine mass should not assume that the mass is cancer.
But the higher incidence of uLMS is one reason I believe Black women should be particularly comfortable asking questions about the diagnosis, tissue removal, morcellation, and pathology before surgery.
A reasonable question is:
“Because uterine leiomyosarcoma occurs more often in Black women, does anything about my mass or my medical history make you concerned about an unexpected sarcoma?”
Previous Radiation to the Pelvis
Previous radiation treatment to the pelvis is another established risk factor for uterine sarcoma.
The National Cancer Institute identifies previous pelvic radiation therapy as a risk factor for uterine sarcoma. Reviews of uLMS specifically identify prior pelvic radiation as a potential risk factor as well.
If you previously received radiation to the pelvis for another cancer or medical condition and now have a uterine mass, make sure your surgeon knows.
This does not mean the mass is cancer.
It means your history is relevant.
I would ask:
“Does my previous pelvic radiation change how you want this uterine mass removed?”
Tamoxifen Use
Tamoxifen is another important medical history item.
Tamoxifen is commonly used to treat or prevent certain types of breast cancer. The National Cancer Institute identifies tamoxifen treatment as a risk factor for uterine sarcoma.
A review specifically addressing uLMS also identifies long-term tamoxifen exposure as a risk factor.
If you currently take tamoxifen or have taken it for an extended period, tell your gynecologist and surgeon.
The NCI recommends that women taking tamoxifen have appropriate pelvic follow-up and report abnormal vaginal bleeding.
Again, this does not mean that a uterine mass in someone who has taken tamoxifen is automatically cancer.
It means the history should not be overlooked.
Certain Inherited Cancer Syndromes
Some rare inherited cancer syndromes are associated with an increased risk of leiomyosarcoma.
These include Li-Fraumeni syndrome and hereditary retinoblastoma, among others described in the medical literature.
These conditions are uncommon.
Most women with uterine fibroids do not have them.
But a strong personal or family history of unusual cancers, particularly cancers occurring at unusually young ages, is something a doctor should know about.
If you have been diagnosed with a hereditary cancer syndrome or have a significant family history of rare cancers, ask whether that information changes the way your uterine mass should be evaluated or removed.
A Rapidly Growing or Unusual Uterine Mass
Growth deserves attention, but this is an area where patients need accurate information.
A rapidly enlarging uterine mass has traditionally been considered a possible warning sign for uterine sarcoma. However, rapid growth by itself cannot reliably distinguish a fibroid from leiomyosarcoma.
In other words:
A rapidly growing fibroid is not automatically cancer.
At the same time, a mass that is growing rapidly, appears unusual on imaging, develops after menopause, or otherwise does not behave as expected deserves careful evaluation.
A recent review notes that rapid growth has historically been considered a concerning feature, while also emphasizing the limitations of using growth alone to predict leiomyosarcoma.
Ask your doctor:
“Does the growth pattern of this mass raise any concern that it could be something other than a fibroid?”
Abnormal or Heavy Bleeding
Heavy or abnormal uterine bleeding is common with fibroids.
It can also occur with many other gynecologic conditions.
It is not specific for uterine leiomyosarcoma.
That distinction is important.
If you have unusually heavy bleeding, bleeding after menopause, or a significant change in your normal bleeding pattern, it deserves medical evaluation.
The concern becomes particularly important when abnormal bleeding occurs alongside other factors such as postmenopausal status, a growing uterine mass, unusual imaging, or a history of tamoxifen use.
The NCI specifically advises women taking tamoxifen to report abnormal vaginal bleeding promptly.
Do not assume:
“It is just another symptom of my fibroid.”
Ask whether the bleeding has been adequately evaluated.
Pain, Pressure, or Abdominal Enlargement
Pelvic pain, pressure, abdominal enlargement, urinary symptoms, and bowel symptoms can all occur with fibroids.
They are not specific signs of uLMS.
That means these symptoms should not be used by themselves to tell a woman that she has cancer.
But persistent, worsening, unusual, or unexplained symptoms deserve evaluation—particularly when they occur together with a uterine mass that is growing or has unusual imaging characteristics.
The important question is not:
“Do I have symptoms?”
It is:
“Does the entire picture fit comfortably with a benign fibroid, or is there anything about my situation that deserves additional evaluation?”
The Combination of Factors Matters
Sometimes there is not one dramatic warning sign.
Instead, there may be several pieces of information.
For example:
You are postmenopausal
You are over 50
You have a rapidly enlarging uterine mass
You have unusual imaging findings
You have a history of pelvic radiation
You have taken tamoxifen
You have a significant personal or family cancer history
You have a known hereditary cancer syndrome
You are Black, a population in which uLMS has been reported at a higher incidence
Your symptoms or clinical findings do not fit neatly with what your doctor normally expects from a fibroid
None of these factors proves that a mass is leiomyosarcoma.
But when several concerns are present, I believe it is reasonable for a patient to ask more questions before surgery.
The Question I Most Want Patients to Ask
The problem is that doctors cannot reliably identify every uterine leiomyosarcoma before surgery.
That uncertainty is exactly why I want patients to understand the method of tissue removal.
If there is a possibility—however small—that a presumed fibroid could actually be a uterine sarcoma, ask:
“How will you remove this mass if it turns out to be cancer?”
Then ask:
“Will you have to cut it into pieces to get it out?”
And:
“What alternatives would allow the mass to be removed intact?”
Those questions do not mean you think your doctor is wrong.
They mean you understand that the diagnosis may not be completely certain until the tissue has been examined.
Having a Risk Factor Does Not Mean You Have Cancer
I want to emphasize this because I do not want this article to create unnecessary fear.
A woman can be Black and have a completely benign fibroid.
A woman can be over 50 and have a completely benign fibroid.
A woman can have heavy bleeding and have a completely benign fibroid.
A woman can have taken tamoxifen and never develop uterine sarcoma.
A woman can have a rapidly growing fibroid and never have cancer.
And a woman can have none of these risk factors and still develop uterine leiomyosarcoma.
That is one of the difficult realities of this disease.
Risk factors help doctors assess concern. They do not provide a diagnosis.
The reason I want patients to know about them is not so they can diagnose themselves.
It is so they can have a more informed conversation about evaluation, surgery, morcellation, intact removal, and pathology.
If You Have One of These Factors, Ask More Questions
If you have been told that you have a uterine fibroid or uterine mass and you also have one or more of these risk factors or concerning findings, do not panic.
Instead, become an informed participant in the surgical decision.
Ask your doctor:
How confident are we that this is a fibroid?
What features make you confident it is benign?
Is there anything about my age or medical history that changes your concern?
How will the mass be removed?
Will it be removed intact?
Will any part of it be cut into pieces?
Will power morcellation be used?
If power morcellation is being considered, will an appropriate containment system be used?
What alternatives are available?
Would removal through a larger incision allow the mass to be removed intact?
Would consultation with a gynecologic oncologist be appropriate?
Who will examine the specimen?
Would expert pathology review be appropriate if the diagnosis is unusual?
You are not diagnosing yourself.
You are asking how uncertainty is being managed.
My Message Is Simple
I am not telling women to be afraid of fibroids.
I am not telling women to refuse minimally invasive surgery.
I am not telling women that every rapidly growing mass is cancer.
I am not telling women that being Black, being older, having heavy bleeding, taking tamoxifen, or having another risk factor means they have uterine leiomyosarcoma.
I am saying something much simpler:
When doctors cannot reliably rule out every uterine leiomyosarcoma before surgery, patients deserve to understand how their uterine mass will be removed.
If you have additional risk factors or concerning findings, that conversation may be even more important.
Before surgery, ask how the tissue will leave your body.
Because once the operation begins, the decision about whether that tissue stays intact may already have been made.
What the FDA Says About Power Morcellation
The FDA currently recommends that laparoscopic power morcellation be performed only in appropriately selected patients and, when it is used, with a legally marketed tissue-containment system.
The FDA also recommends against using laparoscopic power morcellators when the tissue is known or suspected to contain cancer.
For presumed fibroids, the FDA recommends against laparoscopic power morcellation in patients who are postmenopausal or over age 50, and in patients who are candidates for removal of the tissue intact through the vagina or through a mini-laparotomy incision.
These recommendations are specifically about laparoscopic power morcellation. They should not be interpreted as a ban on every form of morcellation or every minimally invasive uterine procedure.
The FDA's current guidance emphasizes patient selection, tissue containment when power morcellation is appropriate, and informed discussion of risks and alternatives.
Contained Morcellation Is Different From Uncontained Morcellation
The word morcellation does not tell you everything about how the procedure will be performed.
With uncontained morcellation, tissue is fragmented within the surgical field without a containment system surrounding it.
With contained morcellation, the tissue is placed inside a specially designed containment system before power morcellation is performed.
The purpose of a containment system is to isolate the tissue and reduce the possibility of tissue dispersal during the procedure.
The FDA recommends that when laparoscopic power morcellation is appropriate, it be performed with a compatible, legally marketed tissue-containment system.
But contained does not mean risk-free.
Containment cannot eliminate every possible risk associated with an unsuspected malignancy. Patients should still understand why morcellation is being considered and what alternatives are available.
Laparoscopic Surgery Is Not Automatically the Problem
This distinction is important.
Laparoscopic surgery can offer meaningful benefits for many patients.
Compared with an open abdominal operation, minimally invasive surgery may involve smaller incisions, less postoperative pain, shorter hospitalization, and faster recovery.
The concern is not simply:
“Is my surgery laparoscopic?”
The more useful question is:
“How will the uterus or mass be removed?”
A laparoscopic hysterectomy may be performed without power morcellation.
Depending on the patient's anatomy and circumstances, tissue may be removed intact through the vagina, through a larger incision, or by another approach.
The surgical method should be chosen by balancing the benefits and risks for that individual patient.
Why Intact Removal May Be Considered
If cancer is suspected, morcellation of the tumor is contraindicated.
When cancer cannot be reliably ruled out, removing a uterus or mass intact may reduce the possibility of mechanically dispersing malignant tissue.
That does not mean an open abdominal operation is automatically the safest choice for every patient.
An abdominal hysterectomy or myomectomy also carries greater surgical burdens than many minimally invasive procedures, including longer recovery and higher rates of some complications.
ACOG therefore recommends shared decision-making that considers the risks and benefits of each surgical approach, the possibility of an unsuspected malignancy, and alternatives to morcellation.
The question is not:
“Is a bigger incision always better?”
It is:
“Which approach makes the most sense for this patient given what we know and what we cannot know before surgery?”
What Can Doctors Know Before Surgery?
Before considering morcellation, physicians evaluate the patient for factors that could increase concern for malignancy.
Preoperative evaluation may include:
Medical history
Age and menopausal status
Symptoms
Physical examination
Imaging
Appropriate cervical cancer screening
Endometrial evaluation when indicated
Review of concerning clinical findings
However, even a careful preoperative evaluation cannot reliably identify every uterine leiomyosarcoma.
ACOG specifically notes that leiomyosarcoma cannot be reliably diagnosed before surgery in every case.
That uncertainty is one of the reasons informed consent matters.
Does a Rapidly Growing Fibroid Mean Cancer?
Not necessarily.
Rapid growth has historically raised concern, but ACOG notes that research has not established uterine size or rapid uterine growth as reliable predictors of leiomyosarcoma.
That is important because patients sometimes hear:
“It grew quickly, so it must be cancer.”
That is not an appropriate conclusion.
At the same time, a rapidly changing mass or new symptoms should still be evaluated by a healthcare professional.
The complete clinical picture matters.
Why Pathology Matters
After surgery, the removed tissue is examined by a pathologist.
Pathology can determine whether the tissue is consistent with a benign fibroid or another condition, including cancer.
In difficult cases, additional studies or specialist pathology review may be appropriate.
If an unusual diagnosis is suspected or identified, patients can ask whether review by a pathologist with expertise in gynecologic tumors or sarcoma pathology would be appropriate.
Patients can also ask how their tissue will be preserved and whether additional testing might be needed later.
The important point is that the surgical procedure and the pathology examination are connected but different parts of diagnosis.
The surgeon determines how the tissue is removed.
The pathologist evaluates what the tissue contains.
Both matter.
What Happens if an Unexpected Cancer Is Found?
If pathology unexpectedly identifies uterine leiomyosarcoma after surgery, the next steps depend on the individual circumstances.
Doctors may need to review:
The original pathology
The operative report
Imaging
The extent of disease
Whether additional surgery is needed
Whether further staging is appropriate
Whether oncology consultation is appropriate
Whether additional treatment should be considered
The appropriate response varies from patient to patient.
If you have already undergone surgery and later receive an unexpected cancer diagnosis, ask your healthcare team to explain what was found and what it means for your next steps.
Questions to Ask Before Fibroid Surgery
You do not need to know the medical terminology before your appointment.
About the diagnosis
What makes you believe this is a fibroid?
Are there any features that concern you?
How was the mass evaluated?
Can leiomyosarcoma be ruled out before surgery in my case?
About tissue removal
Will the uterus or mass be removed intact?
Will any tissue be cut into pieces?
Will manual morcellation be used?
Will power morcellation be used?
If power morcellation is planned, will a tissue-containment system be used?
Why is morcellation appropriate for me?
What alternatives are available?
About the surgical approach
Could the uterus or mass be removed intact through the vagina?
Could it be removed through a mini-laparotomy or another incision?
Would an open abdominal procedure change the risk in my situation?
What are the benefits and risks of each approach?
About cancer risk
Does my age or menopausal status change the risk?
Do my symptoms or imaging findings raise concern?
Would a gynecologic oncologist's opinion be useful before surgery?
About pathology
Who will examine the tissue?
What happens if the pathology is unusual?
Would specialist pathology review be appropriate?
Will the tissue be preserved in case additional testing is needed?
These are not unreasonable questions.
They are part of understanding what you are consenting to.
Ask the Question Most Patients Do Not Think to Ask
Before surgery, ask:
“Will you have to cut up the uterus or the mass to get it out?”
That question can open an important conversation.
You can follow it with:
“If you find out afterward that it was cancer, what would the fact that it was morcellated mean?”
And:
“What are my alternatives if I don't want the mass fragmented?”
You do not need to make the decision based on fear.
You need enough information to make the decision knowingly.
If You Are Over 50 or Postmenopausal
Age and menopausal status are particularly important when discussing laparoscopic power morcellation.
The FDA recommends against laparoscopic power morcellation for presumed fibroids in patients who are postmenopausal or over age 50. It also recommends against its use when the tissue can be removed intact through the vagina or through a mini-laparotomy incision.
If this applies to you, ask your surgeon specifically why power morcellation is being considered and what alternatives are available.
If You Are Already Scheduled for Surgery
If your surgery is approaching, do not assume that the surgical plan cannot be discussed again.
Call your surgeon's office and ask:
“Can you confirm how the uterus or fibroid will be removed and whether morcellation is planned?”
If you are unsure about the answer, ask for clarification before the procedure.
You can also ask:
“Will power morcellation be used?”
If the answer is yes, ask:
“Will a tissue-containment system be used, and why is this approach appropriate for me?”
The FDA specifically recommends that patients discuss whether power morcellation will be used, why it is appropriate, whether containment will be used, and what other treatment options exist.
If You Already Had Morcellation
If you are reading this after surgery, take a breath.
Morcellation does not mean you had cancer.
Most presumed fibroids are benign.
It also does not mean that you will develop cancer.
If you are concerned about what happened during your surgery, you can ask your healthcare provider for copies of:
Your operative report
Your pathology report
Your surgical consent
Relevant imaging reports
Any documentation describing the method of tissue removal
You can ask whether the tissue was:
Removed intact
Manually fragmented
Power-morcellated
Contained during morcellation
Removed through another route
If you later receive an unexpected cancer diagnosis, make sure your oncology team knows the details of the original surgery.
They can determine what information is medically relevant to your care.
Morcellation Does Not Mean Cancer Will Spread
This distinction is important.
If a woman has a benign fibroid and undergoes morcellation, she does not suddenly have cancer.
If a woman has an unsuspected leiomyosarcoma, morcellation may create a risk of mechanically disseminating malignant tissue within the abdomen or pelvis.
But it is not scientifically accurate to say that every morcellated cancer will spread because of the procedure.
Uterine leiomyosarcoma can spread through natural biological pathways, including hematogenous and intraperitoneal routes. Evidence regarding the exact effect of morcellation on prognosis has limitations, and studies have not produced perfectly consistent results. ACOG describes the evidence as limited and notes the difficulty of drawing definitive conclusions from retrospective studies.
That is why responsible patient education should explain the risk without claiming certainty about what happened in an individual case.
The Decision Is Not Simply “Small Scar or Big Scar”
It is tempting to reduce the conversation to:
Small incision versus large incision.
The actual decision is more complicated.
A minimally invasive approach may offer meaningful recovery advantages.
An open procedure may avoid fragmentation of a uterine mass.
Contained power morcellation may reduce tissue dispersal when power morcellation is considered appropriate.
Every surgical approach has risks.
The right decision depends on the patient, the diagnosis, the size and location of the mass, the surgical anatomy, cancer risk, available alternatives, and the surgeon's clinical judgment.
That is why shared decision-making matters.
What I Want Patients to Understand
If you remember only a few things from this article, remember these:
Most fibroids are benign.
Uterine leiomyosarcoma is rare.
Leiomyosarcoma cannot be reliably ruled out before surgery in every case.
Morcellation means tissue is divided into smaller pieces.
Laparoscopic surgery does not automatically mean morcellation.
Power morcellation and contained morcellation are not the same thing.
The FDA recommends contained power morcellation only for appropriately selected patients when power morcellation is appropriate.
Patients should understand how their uterus or mass will be removed before surgery.
Patients should understand the alternatives.
The goal is informed decision-making—not fear.
My Personal Story Is a Separate Article
I have written another article about what happened to me personally.
It is different from this one.
My personal story explains how my presumed fibroid surgery, morcellation, original pathology, later diagnosis of metastatic uterine leiomyosarcoma, and patient advocacy changed my life.
This article is different.
It is intended as a patient education guide for someone who is considering uterine surgery now.
I wrote it because I want patients to know the questions I did not know to ask before my own surgery.
You can read my personal story separately if you want to understand what happened to me.
But you do not need to have my experience to benefit from asking questions before surgery.
A Final Question to Take to Your Surgeon
Before your surgery, ask:
“How will the uterus or mass physically leave my body?”
Then ask:
“Will it be removed intact, or will it be cut into pieces?”
And if morcellation is planned:
“Why is that approach appropriate for me, will containment be used if power morcellation is planned, and what alternatives do I have?”
Those questions do not mean you believe you have cancer.
They mean you understand that surgery is a decision—not just a procedure.
You deserve to understand what will happen to your body before you consent to it.
Frequently Asked Questions
Are uterine fibroids cancer?
No. Most uterine fibroids are benign growths. Uterine leiomyosarcoma is a separate, rare malignant tumor.
Can doctors tell whether a fibroid is cancer before surgery?
Not reliably in every case. Preoperative evaluation can identify findings that raise or lower concern, but leiomyosarcoma cannot currently be ruled out with certainty before surgery.
What is morcellation?
Morcellation is the process of dividing tissue into smaller pieces so it can be removed through a smaller opening.
Is morcellation always performed with a power device?
No. Tissue can be fragmented manually or with a powered morcellator.
Is laparoscopic surgery the same as morcellation?
No. Laparoscopic surgery is a surgical approach using small incisions. Morcellation is one possible method of removing tissue during some minimally invasive procedures.
Does the FDA ban all morcellation?
No. The FDA's recommendations specifically address laparoscopic power morcellation and recommend that it be used only in appropriately selected patients and with a legally marketed tissue-containment system when it is appropriate.
Is contained morcellation completely safe?
No. Containment is intended to reduce tissue dispersal, but it does not eliminate every risk associated with an unsuspected malignancy.
Should every woman with fibroids have an open hysterectomy?
No. Surgical decisions need to balance the risks and benefits of minimally invasive and open approaches for the individual patient. ACOG recommends shared decision-making about these choices.
Should I see a gynecologic oncologist before fibroid surgery?
Not every patient needs an oncology consultation. If there are concerning findings or uncertainty about the diagnosis or surgical approach, it is reasonable to ask your doctor whether a gynecologic oncology consultation would be useful.
What should I do if I already had morcellation?
Do not assume that you have cancer. If you are concerned, ask your healthcare provider for your operative and pathology reports and discuss the procedure and results with your doctor.
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References
U.S. Food and Drug Administration. “Update: Perform Only Contained Morcellation When Laparoscopic Power Morcellation Is Appropriate.”
U.S. Food and Drug Administration. “Laparoscopic Power Morcellators.”
U.S. Food and Drug Administration. “Product Labeling for Laparoscopic Power Morcellators.”
U.S. Food and Drug Administration. “FDA Allows Marketing of First-of-Kind Tissue Containment System for Use With Certain Laparoscopic Power Morcellators in Select Patients.”
National Cancer Institute. “Leiomyosarcoma.”
https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-soft-tissue-tumors/leiomyosarcoma
National Cancer Institute. “Uterine Sarcoma Treatment (PDQ®)–Patient Version.”
National Cancer Institute. “Uterine Sarcoma Treatment (PDQ®)–Health Professional Version.”
Mayo Clinic. “Uterine Fibroids: Symptoms and Causes.”
Uterine Sarcoma Treatment (PDQ®)–Patient Version
Uterine Sarcoma Treatment (PDQ®)–Health Professional Version
Radiological Society of North America (RSNA)MRI Evaluation of Uterine Masses for Risk of Leiomyosarcoma: A Consensus Statement
Peer-Reviewed Medical Literature
Epigenetic Features in Uterine Leiomyosarcoma and Endometrial Stromal Sarcomas: An Overview of the Literature
U.S. Food and Drug Administration (FDA)Laparoscopic Power Morcellators
Update: Perform Only Contained Morcellation When Laparoscopic Power Morcellation Is Appropriate
Trusted Medical Sources
U.S. Food and Drug Administration — Power Morcellation During Gynecologic Laparoscopic Surgeries
U.S. Food and Drug Administration — Contained Morcellation Safety Communication
American College of Obstetricians and Gynecologists — Uterine Morcellation for Presumed Leiomyomas
U.S. Food and Drug Administration — Product Labeling for Laparoscopic Power Morcellators
About the Author:
Deborah Ann Martin is the founder of Surviving Life Lessons, a published author, poet, speaker, and trainer with over 20 years of management experience across multiple industries. An MBA graduate, U.S. veteran, single mother, and rare cancer survivor, Deborah brings both professional expertise and lived experience to her writing on resilience, leadership, personal growth, and overcoming adversity. Her mission is to empower others with practical wisdom and real-life insight to navigate life’s challenges with strength and purpose.
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