Just prior to the FDA guidance on the use of power morcellators, Johns Hopkins made public a new care plan for managing fibroids or hysterectomies in women over age 50 years.
To minimize the risk of spreading occult malignancy, Johns Hopkins University in Baltimore no longer uses uterine morcellation for fibroids or hysterectomies in women over age 50 years.
Morcellation is also contraindicated under the Hopkins protocol if women have other risk factors for gynecologic cancer, including tamoxifen use, pelvic radiation, hereditary cancer syndromes, and BRCA mutations.
For women who qualify, morcellation can be performed only by high-volume surgeons who isolate their targets within an endoscopy bag to catch spills. Case peer-review, endometrial sampling, and imaging—including an MRI for fibroids—are required beforehand to rule out occult malignancy, and women must be warned of the risk of occult malignancy before opting for morcellation.
Link to the full article in The Oncology Report: http://bit.ly/1zBqIkv