Working out of Yale New Haven Hospital and Smilow Cancer Hospital, the Gynecologic Pathology program is a fundamental component in the prevention, diagnosis, and treatment of diseases of the female genital organs. Our pathologists are subspecialty-trained and highly experienced, with a passion for patient care. The program emphasizes diagnostic tissue evaluation, oncological biomarker identification, and clinical applications, as well as understanding the pathogenesis of various gynecological cancers. We encounter a high volume of complex, neoplastic gynecologic surgical specimens from the Yale Gynecologic Oncology Service and biopsy specimens from many outpatient clinics in the greater New Haven area. Beyond routine tissue diagnosis, team members actively participate in the real-time decision-making process for patient management, including daily intraoperative consultation, weekly gynecologic tumor conferences, and many ongoing cancer clinical trial programs. We have a national and international reputation as experts in the diagnosis of gestational trophoblastic diseases (complete and partial hydatidiform moles, gestational trophoblastic tumors) and endometrial cancer. We are among the few institutions to offer molecular genotyping as part of the routine diagnostic algorithm for molar pregnancies. Our services include examination of the following: Ovarian cancer, endometrium, and cervix Infertility, placental evaluation, endometrial hyperplasia, dysfunctional uterine bleeding, cervical Pap smear, sexually transmitted diseases, cervical dysplasia

The focus of the team of clinicians who form the Gynecologic Oncology Program at Smilow Cancer Hospital is to provide comprehensive and compassionate care for women with gynecologic cancers. Women diagnosed with vulvar, vaginal, cervical, uterine, fallopian tube, or ovarian cancers are provided with exceptional care from Yale’s experienced team of gynecologic oncologists at the hospital’s dedicated Women’s Center. In addition, the team also treats soft tissue tumors of the pelvis, gestational trophoblastic disease, as well as women with precancerous changes that have been identified in the vulva, vagina, and cervix, including dysplasia and carcinoma in situ, or premalignant changes of the endometrium, including adenomatous hyperplasia. The physicians of the Gynecologic Oncology Program offer a wide spectrum of advanced strategies for the diagnosis and treatment of gynecologic cancers, including colposcopy evaluation, conformal radiotherapy, and novel, targeted chemotherapies. The multidisciplinary program has experts from the obstetrics, gynecology, and reproductive sciences; radiation oncology; radiology and biomedical imaging; genetics; pathology; pharmacy; and social work. A dedicated patient coordinator facilitates patient appointments and communication, coordinates services, and supports each patient and their family. Surgery for previously untreated gynecologic cancer Surgical treatment of cancer is the most common option for previously untreated cancers. These operations include radical hysterectomies for cervical cancer, cytoreductive surgery for ovarian cancer, radical vulvectomies for vulvar cancer and total abdominal hysterectomies, bilateral salpingo-oophorectomies, and lymphadenectomies for the staging and treatment of endometrial cancers. Conventional laparoscopic and robotic surgery is available to women in need of surgery for uterine cancer, as well as for removal of the uterus, tubes, and ovaries. Prophylactic surgery, including hysterectomy, bilateral salpingo-oophorectomy, or bilateral salpingectomy with ovarian conservation, is also available to women looking to prevent ovarian cancer occurrence. Preservation of fertility in women with gynecologic cancers whenever possible is always a priority. We perform radical trachelectomies in women with early-stage cervical cancer who desire fertility preservation. For women with early-stage, low-grade endometrial cancers, hormonal therapy is prescribed. Chemotherapy Management The Gynecologic Oncology Program provides a full spectrum of chemotherapeutic agents used in the management of ovarian cancer, fallopian tube cancer, uterine cancer, mesenchymal tumors of the uterus, cervical cancer, vaginal cancer, and vulvar cancer. These chemotherapeutic agents may be used either for primary treatment or treatment of recurrent disease. Neoadjuvant chemotherapy, i.e., chemotherapy prescribed before surgical treatment, is often used for women with advanced ovarian cancer to reduce the s

Established in 1990, the Ovarian Cancer Early Detection Program provides women with new methods for the prevention, early detection, and treatment of gynecologic cancers. The direct connection between the research lab and patient care makes ours the leading center for women’s reproductive cancer research and treatment. The ovary is the fifth most common site for cancer to develop in American women. However, it is the fourth leading cause of cancer deaths in American women. There are more deaths from ovarian cancer than from cervical and uterine cancers combined. The program aims to identify ovarian cancer in its early stages when it is highly curable. We are committed to providing a comprehensive approach to treating reproductive cancers. Our multidisciplinary team is composed of physicians, scientists, nurses, genetic counselors, geneticists, and other medical staff. The Ovarian Cancer Early Detection Program was established in order to identify: Screening tests that are the most appropriate for detecting early ovarian cancer The frequency with which these tests should be employed How frequently these tests are normally performed We offer the following specialized services for women: Risk assessments, including genetic counseling and physical examinations The latest surgical interventions and postoperative treatment New diagnostic imaging and ultrasound technologies Opportunities for women with normal physical and ultrasound examination results and also for women with ovarian cancer to participate in approved clinical trials to develop new treatments Our approach to ovarian and other gynecological cancers is rooted in a program called Discovery to Cure, a broad initiative launched by Yale to combat all reproductive cancers. The program combines the cutting-edge research we do in the lab with a multidisciplinary team approach to patient care and the latest early detection methods.