Endometrial Cancer Diagnosis

If you have symptoms that suggest uterine or endometrial cancer, your doctor will try to find out what’s causing the problems.

Tests Used to Diagnose Endometrial Cancer

You may have a physical exam and blood tests. Also, you may have one or more of the following tests:

• Pelvic exam: Your doctor can check your uterus, vagina, and nearby tissues for any lumps or changes in shape or size.
• Ultrasound: An ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside the pelvis. The echoes create a picture of your uterus and nearby tissues. The picture can show a uterine tumor. For a better view of the uterus, the device may be inserted into the vagina (transvaginal ultrasound).
• Biopsy: The removal of tissue to look for cancer cells is a biopsy. A thin tube is inserted through the vagina into your uterus. Your doctor uses gentle scraping and suction to remove samples of tissue. A pathologist examines the tissue under a microscope to check for cancer cells. In most cases, a biopsy is the only sure way to tell whether cancer is present.

Tumor Grade

If cancer is found, the pathologist studies tissue samples from the uterus under a microscope to learn the grade of the tumor. The grade tells how much the tumor tissue differs from normal uterine tissue. For endometrial cancer, the grade is based on how closely the cancer cells are organized into glands that look like normal endometrial cells. The following grades can be applied to endometrial cancer:

• Grade 1: Tumors have 95% or more of the cancer tissue forming glands. This is typically a slower-growing cancer. Most endometrial cancers fall into this grade.
• Grade 2:  Tumors have between 50% and 94% of the cancer tissue forming glands.
• Grade 3: Tumors have less than half of the cancer tissue forming glands. Grade 3 cancers tend to be aggressive (they grow and spread fast) and have a worse outlook than lower-grade cancers.

The tumor grade will help the gynecologic oncologist determine the best treatment approach.