Your doctor will ask about your past health. Information about family history of uterine cancer is also important. A physical and pelvic exam will be done. Your doctor may suspect uterine cancer based on your symptoms. The doctor will need to rule out other causes. Tests will be needed to confirm that cancer is present.
Tests to rule out other conditions and confirm cancer include:
An ultrasound can measure the thickness of the endometrium. Thicker areas will need further testing. The ultrasound wand may be moved over the belly or inserted into the vagina.
A hysteroscope will let the doctor view the tissue directly. A scope will be passed into the vagina and cervix to the uterus. The scope will have a light and a camera to see the tissue.
A biopsy will confirm cancer. It will also provide other important details about the cancer. An area of suspicious tissue is removed. It will be examined under a microscope. Different biopsy methods include:
Tests will help determine the stage of cancer. Staging is used to identify characteristics of the tumor. This will help to make a treatment plan. Staging will consider how far the original tumor has spread, if lymph nodes are involved, or if cancer has spread. Other details about cancer cells can also be found that will help target the specific cancer.
Surgical staging is done with an exploratory laparotomy. An incision is made in the abdominal wall to gain access to the abdominal and pelvic cavities. The areas can be examined for the presence of tumors. For uterine cancer, this may include surgical removal of tumors, tissue, or organs in advance of other staging tests.
Tests to help with staging may include:
Uterine cancer is staged from I-IV (1-4):
Uterine cancer can be graded by how cells looks under a microscope. Uterine cancer is grouped as low or high risk.
Grades 1-2 have the best prognosis.
Prognosis is an estimate of the course and/or outcome of a disease or condition. It is most often expressed as the percentage of patients who are expected to survive over 5 or 10 years. Cancer prognosis is not exact, but best estimate with information available.
On average, the 5-year survival rate for uterine cancer is about 81%. Individual rates depend on the stage of the cancer at the time of diagnosis. Uterine cancer found in the earliest stages (stage IA) offer the best chance for a cure. Survival rates can be as high as 90%. Survival rates decrease as cancer stages increase. Women with stage IV uterine cancer have a survival rate around 15%.
Cancer stats facts: Endometrial cancer. National Cancer Institute website. Available at: https://seer.cancer.gov/statfacts/html/corp.html. Accessed December 14, 2017.
Endometrial cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113952/Endometrial-cancer. Updated May 24, 2017. Accessed December 14, 2017.
Endometrial cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/endometrial-cancer. Updated March 2017. Accessed December 14, 2017.
Endometrial cancer. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/Patients/FAQs/Endometrial-Cancer. Updated June 2016. Accessed December 14, 2017.
Stages of endometrial cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq#section/_111. Updated October 13, 2017. Accessed December 14, 2017.
Tests for endometrial cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/endometrial-cancer/detection-diagnosis-staging/how-diagnosed.html. Updated November 20, 2017. Accessed December 14, 2017.
Last reviewed December 2017 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP Last Updated: 12/14/2017