Endometrial Cancer: Diagnosis
How is endometrial cancer diagnosed?
If your healthcare provider thinks you might have endometrial cancer, usually because
of abnormal bleeding, you'll 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 provider asking you questions. They'll ask about
your health history, symptoms, risk factors, and family history of disease. Your 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 providers specialize in treating cancers and other diseases of the female reproductive
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 provider may do a biopsy if the endometrium looks
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 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's 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 provider’s office. It may
also be done during a D&C.
Dilation and curettage (D&C)
Your provider may recommend a D&C if an endometrial biopsy isn't 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 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 provider has the results of your tests, they'll 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. Make sure you understand the
results and what follow-up you need.