Myomas are much more complex and varied than we give them credit for. To me it is like the 19th century concept of cancer: cancer is cancer and there is no need to understand the type. Only when you understood differences in prognosis and pathophysiology did it make sense to differentiate a thyroid cancer from a lymphoma and an ER+PR+ breast cancer from a triple negative one. I think because we’ve relied too much on hysterectomy, we consider all fibroids the same. I think in the next decade we will understand better the molecular subtypes of myomas and our current way of making decisions will seem pretty primitive.
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