Endometrial Cancer: Diagnosis
How is endometrial cancer diagnosed?
If your healthcare provider thinks you might have endometrial cancer, you will need
certain exams and tests to be sure. Endometrial cancer is cancer that starts in the
lining of the uterus (endometrium). Diagnosing endometrial cancer starts with your
healthcare provider asking you questions. He or she will ask about your health history,
your symptoms, risk factors, and family history of disease. Your healthcare provider
will also give you a physical exam. This will include a pelvic exam.
Diagnosis may be done by a gynecologist. Or you may see a gynecologic oncologist.
These healthcare providers specialize in treating cancers and other diseases of the
female reproductive organs.
What tests might I need?
You may have one or more of the following tests:
Transvaginal ultrasound (ultrasonography)
An ultrasound test uses sound waves to create images on a computer screen. It’s done
with a small wand called a transducer that’s placed in the vagina. The test creates
pictures of the uterus. Ultrasound can show tumors and can be used to measure the
thickness of the endometrium. The healthcare provider may do a biopsy if the endometrium
looks too thick.
Sometimes a small tube is used to fill the uterus with salt water before doing the
ultrasound. This may be called a hysterosonogram or a saline infusion sonogram. The
saline helps the healthcare provider get a better image of any changes in the lining
of the uterus.
A biopsy is when small pieces of tissue are taken and looked at with a microscope.
A biopsy is the only way to confirm cancer. An endometrial tissue sample is collected
by using a small flexible tube that is put into the uterus. Suction is used to pull
out the tissue. The tissue sample is examined to see if there are cancer cells or
other abnormal cells in it. This biopsy is often done in a healthcare provider’s office. It
may also be done during a D&C.
Dilation and curettage (D&C)
Your healthcare provider may recommend a D&C if an endometrial biopsy is not possible
or more information is needed. This is a minor surgery in which the cervix is opened
(dilated). The cervical canal and uterine lining are then scraped with a spoon-shaped
tool called a curette. A pathologist looks at the tissue for cancer cells. Sometimes
your healthcare provider will use a thin, telescope-like tube to look into the uterus
at the same time. This is called a hysteroscopy.
Getting your test results
When your healthcare provider has the results of your tests, he or she will talk with
you about next steps. Your provider will talk with you about other tests you may need
if endometrial cancer is found. This may include repeating the biopsy or more tests.
Make sure you understand the results and what follow-up you need.