Uterine & Endometrial Cancer Diagnosis: Right from the Start

At Roswell Park, we have some of the most advanced imaging tools and pathology resources available so that we get your diagnosis right from the start. 

Not all cancers are created equal. Each is comprised of cells that vary from cancer to cancer, and from individual to individual. And tumors may range in size, from millimeters to inches. Accurately identifying the extent of disease and the makeup of your cancer is imperative when determining the best possible approach to treatment. 

If you have a symptom that suggests uterine cancer, your doctor may check general signs of health and may order blood and urine tests. The doctor also may perform one or more of the following exams or tests:

  • Pelvic exam: The doctor checks the vagina, uterus, bladder and rectum for any lumps or changes in shape or size. To see the upper part of the vagina and the cervix, the doctor inserts an instrument called a speculum into the vagina.
  • Pap test: The doctor collects cells from the cervix and upper vagina. A medical laboratory checks for abnormal cells. Although the Pap test can detect cancer of the cervix, cells from inside the uterus usually do not show up on a Pap test. This is why the doctor collects samples of cells from inside the uterus in a procedure called a biopsy.
  • Transvaginal ultrasound: The doctor inserts an instrument into the vagina. The instrument aims high-frequency sound waves at the uterus. The pattern of the echoes they produce creates a picture. If the endometrium looks too thick, the doctor can do a biopsy.
  • Biopsy: The doctor removes a sample of tissue from the uterine lining. This usually can be done in the doctor's office with an endometrial biopsy. In some cases, however, a woman may need to have a dilation and curettage (D&C). A D&C is usually done as same-day surgery with anesthesia in a hospital. A pathologist examines the tissue to check for cancer cells, hyperplasia, and other conditions.
  • Hysteroscopy:  The doctor inserts a thin, lighted tube into the vagina to examine the cervix and inside of the uterus. This may be done with a D&C.

State-of-the-Art Imaging Technology

With some of the most advanced imaging tools at our fingertips, and physicians trained to maximize their potential, we consistently provide reliable diagnostic results. Quality imaging enables the Roswell Park medical team to develop the best treatment plan and helps the surgeon map the most direct and effective approach to remove an identified tumor.  

One of the more revolutionary imaging devices, the combined Positron Emission Tomography (PET)/Computed Tomography (CT) scanner is used to give a total-body overview of glucose (sugar) metabolism, which can reveal metabolic changes of cancer before anatomic abnormalities can be detected with conventional imaging tools such as stand-alone CT and ultrasound.

Special software is used to fuse PET images with CT scans, providing a union that is both functional and anatomic. PET-CT scans can differentiate malignant from benign tissue and can lead to early detection of recurring cancer. They can also grade tumors, define distant metastases, assist in treatment selection and evaluation.