At your first appointment, we’ll perform a comprehensive physical exam, including a pelvic exam. We may also conduct imaging and other diagnostic tests, such as computed tomography (CT) scanning, magnetic resonance imaging (MRI), and/or positron emission tomography (PET) imaging.
If it appears that uterine (endometrial) cancer might be present, we will perform an endometrial biopsy to take a sample of tissue from the inner lining of the uterus (the endometrium) if this hasn’t already been done by another doctor. In this procedure, a thin, flexible tube is inserted through the cervix into the uterus, and gentle scraping and suction are used to remove a tissue sample. The sample is then sent to our pathologists to examine under a microscope.
We may also perform a hysteroscopy to examine the inside of the uterus with the help of a hysteroscope — a thin, lighted tube with a video camera on its tip — that we insert through the cervix and into the uterus. This procedure also enables us to take tissue for a biopsy.
If a diagnosis still isn’t clear after preliminary tests, we may recommend an outpatient surgical procedure called dilation and curettage (D&C) in which we widen the cervix and gently scrape tissue from inside the uterus. A D&C may require general anesthesia or conscious sedation, in which you take medication to lessen discomfort and anxiety without putting you to sleep. The procedure generally takes about an hour.
Memorial Sloan Kettering pathologists are experts in analyzing biopsy tissue to determine whether cancer is present. The next step is to stage the cancer, which involves determining how much it may have spread.