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Endometrial Cancer Diagnosis

How Is Endometrial Cancer Diagnosed?

Endometrial cancer can be diagnosed at any stage. If women experience any irregular vaginal bleeding, they should consult their physician immediately. Early-stage diagnosis is beneficial because it will improve the outcomes for most women.

If a primary care physician suspects endometrial cancer might be the cause of a patient’s symptoms, they will make a referral to a gynecologist or gynecologic oncologist. These specialists will use one or more of the following methods to diagnose endometrial cancer:

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

Endometrial Biopsy

An endometrial biopsy is needed to confirm a endometrial cancer diagnosis and can be performed in the doctor's office. A thin flexible tube is inserted through the vagina and cervix into the uterus to obtain a tissue sample from the endometrium.

Hysteroscopy: A physician may also insert a very small camera through the vagina and cervix to observe whether any abnormal tissue is present in the uterus.

Dilation and Curettage (D&C)

If an endometrial biopsy is inconclusive in diagnosing a patient, a D&C may need to be performed to collect additional cells from the uterus lining. This is done as an outpatient procedure and may require general or local anesthesia.

Ultrasound Endometrial Cancer

A variety of imaging tests may be done to help diagnose endometrial cancer, but most often, endometrial cancer is diagnosed by performing an ultrasound. Ultrasound is a safe, noninvasive procedure that uses high-frequency sound waves to examine the abdomen. Ultrasound imaging - also called ultrasound scanning or sonography - provides real-time pictures of the body and evaluates size and movement of structures, such as blood flow. Transvaginal ultrasounds may also be used and are performed by inserting a small probe into the vagina to determine the general thickness of the endometrium.

Pathology

To confirm whether the symptoms are associated with endometrial hyperplasia (abnormal enlargement of the endometrium) or endometrial cancer, the biopsy of tissue removed from the endometrium must be sent to the pathology department for analysis. The pathologists will look at the tissue under a microscope to make a final diagnosis.

In collaboration with other specialists, a patient’s physician will likely order one or more diagnostic tests and review the results at a weekly Tumor Board meeting. This interdepartmental review process guides recommendations for treatment. In consultations with the patient and her primary care physician, the Cancer Care Center team plans the best course of treatment based on the type and stage of the patient’s cancer and her overall health.

Staging

Staging is the process of determining how extensive the cancer is. It is an important part of diagnosis because it is used to determine the most appropriate treatment options for patients. The stages of endometrial cancer range from Stage 0 to Stage IV.

Stages of Endometrial Cancer

  • Stage 0 - Cancer is present only in the surface cells of the endometrium.
  • Stage I - Cancer is present only in the uterus.
  • Stage II - Cancer has spread to the connective tissue of the cervix but is still contained to the uterus.
  • Stage III - Cancer has spread outside the uterus and cervix but is contained to the pelvis.
  • Stage IV - Cancer has progressed beyond the pelvis.

(American Cancer Society 2015, National Cancer Institute 2010)

For more detailed information on stages of endometrial cancer, visit the staging section of the American Cancer Society’s endometrial cancer website.

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