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Female patient speaking with doctor

Before a uterine cancer diagnosis is established, a woman might consult with a physician about symptoms she is experiencing, which can include irregular vaginal bleeding or discharge that occurs between menstrual periods or after menopause. The physician will generally inquire about the woman’s risk factors and family medical history, and then perform a general physical and pelvic examination.

Diagnosing uterine cancer with ultrasounds

If a physician suspects uterine (endometrial) cancer, one of the first things they’ll typically do is order an ultrasound of the uterus, ovaries and fallopian tubes to help confirm or rule out the diagnosis. If the patient has endometrial cancer, an ultrasound can help the physician view any tumors or growths (polyps), measure the thickness of the uterine lining (endometrium)—since an abnormally thick lining can indicate cancer—and identify where they would like to collect a tissue sample (biopsy), if any.

Like other types of ultrasounds, an endometrial cancer ultrasound uses sound waves to create an image of the structures within the body. As the technician moves a small wand (transducer) over the area in question, the wand emits high-pitched sound waves, which then echo as they bounce off organs, tissues and other bodily structures. A computer then translates those echoes into images (sonograms), which are displayed on a nearby monitor.

There are numerous types of ultrasounds for uterine cancer, including:

  • Pelvic ultrasounds – The technician moves the wand over the patient’s lower stomach area. For this type of ultrasound, it helps if the patient has a full bladder at the time of the test.
  • Transvaginal ultrasounds – The technician inserts the wand into the patient’s vagina.
  • Saline infusion sonograms (also referred to as “hysterosonograms”) – The technician inserts salt water (saline) into the patient’s uterus prior to the ultrasound, with the goal of making the uterine lining easier to see.

Diagnosing uterine cancer with tissue samples

If there are signs of endometrial cancer on an ultrasound, or if a physician has another reason to suspect uterine cancer, then they will likely order a tissue sample. Because this type of cancer develops inside a woman’s uterus, it is not usually detected through a routine Pap test, which collects cells from the surface of a woman’s cervix. Therefore, in order to determine whether endometrial cancer is present, the physician will need to take a small sampling of tissue from the inner lining of the uterus for evaluation under a microscope.

To confirm a uterine cancer diagnosis, an endometrial tissue sample can be obtained through any of the following procedures:

  • Endometrial biopsy – A thin, flexible tube is inserted into a woman’s uterus through her cervix, and suction is used to remove a small amount of endometrial tissue through the tube.
  • Dilation and curettage – A woman’s cervix is dilated and a curette (small, spoon-shaped instrument) is inserted into the uterus and used to remove tissue. This diagnostic procedure may be done along with a hysteroscopy.
  • Hysteroscopy – A woman’s uterus is filled with saline solution (which can help a physician view the interior more clearly) and a tiny telescope is inserted through her cervix so that a physician can look for and gather samples of suspicious cells or polyps.

The endometrial tissue samples can then be evaluated by a pathologist, who will use a microscope to determine whether cancer cells are present and, if so, confirm a uterine cancer diagnosis.

Choose Moffitt for uterine cancer diagnosis and treatment

At Moffitt Cancer Center, the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, we perform highly focused research and innovative clinical trials, and we continue to gain ground in the diagnosis and treatment of uterine and other forms of cancer. We take pride in knowing that our patient outcomes and survival rates consistently outrank national averages, and that our patients enjoy an enhanced quality of life.

To learn more about uterine cancer diagnosis and the gynecological clinic at Moffitt, please call 1-888-663-3488 or fill out our new patient registration form. No referrals are needed. Because our patients’ cancer diagnoses are our top priority, we make it a point to connect new patients to cancer experts as soon as possible.


American Cancer Society: Tests for Endometrial Cancer
MedLine Plus: Ultrasound