Endometrial Cancer

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Diagnosis

In most cases, endometrial biopsy is used to diagnosis uterine cancer. This outpatient procedure involves inserting a narrow tube into the uterus through the vagina and suctioning out a small amount of tissue from several areas of the uterine wall. The tissue is examined under a microscope and evaluated for cancerous or precancerous abnormalities. The procedure usually takes minutes to perform and provides an accurate diagnosis in 90% of cases.

Sometimes, a dilatation and curettage (D & C) is performed to diagnose the disease. This procedure involves dilating (widening) the cervix and inserting an instrument called a curette into the uterus through the vagina. The curette is used to scrape the uterine wall and collect tissue. In suction curettage, suction is applied through a narrow tube to remove the tissue sample. D & C is an outpatient procedure that takes about an hour and requires general anesthesia.

Patients with certain medical conditions (e.g., severe high blood pressure, obesity, diabetes, metastatic cancer) may be unable to safely tolerate anesthesia. In these patients, imaging tests such as MRI scan, CT scan, transabdominal ultrasound, and transvaginal ultrasound may be used to diagnose cancer of the uterus.

Exploratory laparotomy may be used to stage uterine cancer. Two methods for this procedure include endoscopic laparotomy and open laparotomy.

In endoscopic laparotomy, a lighted, flexible instrument (called an endoscope) is introduced into the abdomen through a small incision and used to examine organs and lymph nodes in the peritoneal cavity. Abnormal tissue is removed for biopsy using tiny instruments that are passed through the endoscope. In open laparotomy, the peritoneal cavity is explored through an abdominal incision.

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