Early and accurate diagnosis of endometrial cancer can help increase the chance for successful treatment. MD Anderson uses the most advanced techniques and technology to diagnose endometrial cancer and find out the exact extent of the disease. This helps your doctor choose the best type of treatment for you. Our staff includes pathologists, diagnostic radiologists and specially trained technicians who are highly skilled in diagnosing endometrial cancer.
Endometrial cancer diagnostic tests
If you have symptoms that may signal endometrial cancer, your doctor will examine you and ask you questions about your health; lifestyle, including smoking and drinking habits; and your family history.
If your doctor thinks you might have endometrial cancer, the first step will be a biopsy. Your doctor will decide the best way to do the biopsy. Methods include:
Endometrial biopsy: A thin, flexible tube is inserted through the cervix and into the uterus. Using suction, a small amount of tissue is removed through the tube.
D&C (dilation and curettage): If an endometrial biopsy does not provide enough tissue or if a endometrial cancer diagnosis is not definite, a D&C may be done. The cervix is dilated (enlarged) with a series of increasingly larger metal rods. A tool called a curette then is used to take cells from the uterus lining.
Hysteroscopy: A thin, telescope-like device with a light (hysteroscope) is put into the uterus through the vagina. The doctor then looks at the uterus and the openings to the Fallopian tubes. Small pieces of tissue can be removed. Hysteroscopy may be done with a D&C.
One or more of the following tests may be used to find out if you have endometrial cancer and if it has spread. These tests also may be used to find out if treatment is working.
Surgery, which may include:
- Hysterectomy: Removal of the uterus
- Bilateral salpingo-oophorectomy: Removal of the uterus, ovaries and Fallopian tubes
- Lymph node dissection: Removal of lymph nodes in the pelvis and lower abdomen
Imaging tests, which may include:
- Ultrasound (link to definition)
- CT or CAT (computed axial tomography) scans
- MRI (magnetic resonance imaging) scans
- PET (positron emission tomography) scans
- Chest X-ray
Blood tests, which may include:
- Complete blood count (CBC)
- CA 125: Endometrial cancers sometimes release this substance into the blood. This test, which is being studied at MD Anderson, measures levels of CA 125. High levels of CA 125 may mean the cancer has spread beyond the uterus or come back after treatment.
The Gynecological Cancer Genetics Clinic at MD Anderson offers genetic testing for some women with endometrial cancer or who are at risk. Genetic counseling may be recommended if you:
- Were diagnosed with endometrial cancer before age 50
- Have had colorectal cancer
- Have any close relatives with colon, rectal or endometrial cancer
- Have a relative who has tested positive for a Lynch syndrome gene mutation (MLH1, MSH2, MSH6, PMS2 genes)
Behavioral and lifestyle changes can help prevent endometrial cancer. Visit our prevention and screening section to learn how to manage your risk.
Some cases of endometrial cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
If you are diagnosed with endometrial cancer, your doctor will determine the stage of the disease.
Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps the doctor plan the best way to treat the cancer.
Once the staging classification is determined, it stays the same even if treatment works or the cancer spreads.
(source: National Cancer Institute)
Stage 1A: Cancer is in the endometrium (uterine lining) only, the inner half of the myometrium (muscle wall), or the glands in the cervix
Stage 1B: Cancer has spread to outer half of the myometrium
Stage 2: Cancer has spread to cervix connective tissue
Stage 3A: Cancer has spread to:
- The outer layer of uterus
- Other pelvic organs including the fallopian tubes or ovaries
Stage 3B: Cancer has spread to the vagina
Stage 3C: Cancer has spread to lymph nodes near the uterus
Stage 4A: Cancer has spread the bladder and/or bowel wall
Stage 4B: Cancer has spread beyond the pelvis, including lymph nodes in the abdomen or groin
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