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Endometrial Cancer: Diagnosis

 
Medical Encyclopedia: Endometrial Cancer: Diagnosis

If endometrial cancer is suspected, a series of tests will be conducted to confirm the diagnosis. The first step will involve taking a complete personal and family medical history. A physical examination, which will include a thorough pelvic examination, will also be done.

The doctor may order an endometrial biopsy. This is generally performed in the doctor's office and does not require anesthesia. A thin, flexible tube is inserted through the cervix and into the uterus. A small piece of endometrial tissue is removed. The patient may experience some discomfort, which can be minimized by taking an anti-inflammatory medication (like Advil or Motrin) an hour before the procedure.

If an adequate amount of tissue was not obtained by the endometrial biopsy, or if the biopsy tissue looks abnormal but confirmation is needed, the doctor may perform a dilatation and curettage (D & C). This procedure is done in the outpatient surgery department of a hospital and takes about an hour. The patient may be given general anesthesia. The doctor dilates the cervix and uses a special instrument to scrape tissue from inside the uterus.

The tissue that is obtained from the biopsy or the D & C is sent to a laboratory for examination. If cancer is found, then the type of cancer will be determined. The treatment and prognosis depends on the type and stage of the cancer.

Trans-vaginal ultrasound may be used to measure the thickness of the endometrium. For this painless procedure, a wand-like ultrasound transducer is inserted into the vagina to enable visualization and measurement of the uterus, the thickness of the uterine lining, and other pelvic organs.

Other possible diagnostic procedures include sonohysterography and hysteroscopy. For sonohysteroscopy, a small tube is passed through the cervix and into the uterus. A small amount of a salt water (saline) solution is injected through the tube to open the space within the uterus and allow ultrasound visualization of the endometrium. For hysteroscopy, a wand-like camera is passed through the cervix to allow direct visualization of the endometrium. Both of these procedures cause dis-comfort, which may be reduced by taking an anti-inflammatory medication prior to the procedure.

— Lata Cherath; Belinda Rowland, Ph.D.



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