Virginia Commonwealth University

VCU Massey Cancer Center

Diagnosis and staging

How is endometrial cancer diagnosed?

Diagnosis includes a medical history and physical examination, including a pelvic examination to feel for masses or growths. A Pap test may be performed as part of the pelvic examination. However, because cancer of the endometrium begins inside the uterus, problems may not be detected using a Pap test. The diagnosis of cancer is confirmed only by a biopsy. Several tests may be used to diagnose endometrial cancer, including:

  • Endometrial biopsy – a procedure in which an endometrial tissue sample is obtained by using a small flexible tube that is inserted into the uterus. The tissue sample is examined under a microscope to determine if cancer or other abnormal cells are present. An endometrial biopsy procedure is often performed in a physician’s office.
  • Dilation and curettage (also called D & C) – a minor operation in which the cervix is dilated (expanded) so that the cervical canal and uterine lining can be scraped with a curette (spoon-shaped instrument). The pathologist examines the tissue for cancer cells.
  • Transvaginal ultrasound (also called ultrasonography) – an ultrasound test using a small instrument, called a transducer, that is placed in the vagina. This test is done to measure the thickness of the uterine lining.

The National Cancer Institute has defined the following stages of uterine cancer generally determined at the time of surgery:

 

Stage I 

The cancer is limited to the body of the uterus.

Stage II 

The cancer has spread from the body of the uterus to the cervix.

Stage III

The cancer has spread outside the body of the uterus to pelvic organs such as the ovaries, tubes, colon or lymph nodes.

Stage IV

The cancer has spread outside the body of the uterus to pelvic organs such as the ovaries, tubes, colon or lymph nodes.