Dr. Katherine LaVigne Mager in her office

Uterine Cancer Diagnosis

If you experience any of the signs and symptoms of uterine or endometrial cancer — especially abnormal vaginal bleeding, spotting or discharge — your physician will want to determine the cause and whether it’s cancer, or a benign, non-cancerous condition or infection. To make this determination, your physician will perform a physical and pelvic exam and one or more of the following tests and procedures:

  • Ultrasound exam. This exam uses sound waves to produce pictures of the inside of your body, particularly your uterus, fallopian tubes and ovaries as well as other pelvic organs and structures. Different techniques such as transvaginal ultrasound and saline infusion ultrasound can help produce better pictures of the uterus or evaluate the endometrial lining and any polyps in the uterus.
  • Hysteroscopy. This procedure, performed under local anesthesia, uses a very thin telescope to allow the physician to see inside the uterus and examine any abnormalities, masses or polyps. Biopsies of any suspicious areas can be taken during hysteroscopy.
  • Endometrial tissue sampling. Taking a small piece or sample of the endometrial tissue to examine under a microscope is essential to determine whether cancer is present or not. The samples are sent to a pathologist, a physician specially trained to analyze the tissue cells, and make a diagnosis. Obtaining these samples may be accomplished during hysteroscopy via several ways, including:
    • Endometrial biopsy. A thin flexible tube with a suction device is inserted through the vagina and into the uterus to remove a small piece of the uterine lining. This may be performed in your doctor’s office.
    • Dilation & curettage (D&C). In this procedure, the cervix is opened (dilated) and the physician uses a special tool to scrape tissue from inside the uterus. A D&C can be performed under general or local anesthesia, conscious sedation or epidural.

If the diagnosis is cancer…

If the pathologist determines that your tissue samples contain cancer cells, you may undergo one or more of the following tests or procedures to learn more information about your cancer and whether it has spread or metastasized beyond the uterus.

  • Chest x-ray to see if cancer has spread to your lungs
  • Computed Tomography (CT) scan which takes multiple x-ray like pictures and a computer assembles them into highly detailed and focused pictures inside the body. CT scan are done to detect whether uterine cancer has spread to other body areas.
  • Magnetic resonance imaging (MRI) scan uses strong magnets and radio waves to create pictures inside the body. MRI scans are useful to determine the cancer’s spread into the uterus and detect enlarged lymph nodes, which may contain cancer cells from the uterus.
  • Positron emission tomography (PET) scan can detect small clusters of cancerous cells in the body. First, you’ll receive an infusion of radioactive glucose, which collects in cancer cells because cancer cells use glucose faster than normal cells. Then a scanner can detect the radioactive clusters.
  • CA-125 blood test. CA-125 is a protein that some endometrial and many ovarian cancers release into the bloodstream A very high level of CA-125 may indicate that cancer has spread beyond the uterus.
  • Genetic screening. At Roswell Park, all patients with endometrial cancer are screened for the genetic condition called Lynch syndrome.

Uterine cancer staging Treatment options