What is the ideal treatment for a 55-years-female with Simple hyperplasia of the endometrium with Atypia?

Management of Atypical Endometrial Hyperplasia: "Hysterectomy is the best treatment for women at any age with atypical endometrial hyperplasia because the risk of concurrent subclinical invasive disease is high." Williams Gynae 1st ed p 691 "In presence of atypia, response to progesterone therapy is poor and the relapse rate is high. Nearly one-third of them will progress to cancer and one-fourth may already have associated undiagnosed cancer. In women approaching or post menopause, hysterectomy is a safer choice in those with complex or atypical hyperplasia."   Jeffcoate 7th/ ed p 425 So Remember: Best management of atypical hyperplasia is hysterectomy. Also, Know Management of Endometrial Hyperplasia: Management depends on the patient's age and the presence or absence of cytological atypia. Non-atypical hyperplasia: Premenopausal women: Progesterone therapy- options: - Medroxyprogesterone acetate for 21 days a month daily for 3 months. Progesterone-containing IUCD. Postmenopausal women Simple hyperplasia without atypia - Generally followed without therapy. Complex hyperplasia without atypia - Cyclical/continuous progesterone therapy. These patients should be followed annually by endometrial biopsy. Atypical hyperplasia: The ideal treatment is a hysterectomy Premenopausal women willing to preserve fertility - High dose progesterone therapy after full information of risk of undiagnosed cancer or progression to cancer. In these cases periodic TVS and endometrial biopsy is necessary.