Fortunately endometrial cancer is usually diagnosed early; approximately 80% of cases are diagnosed as stage I, or confined to the uterus, also called the corpus. This is because most women have symptoms early in the course of the disease that bring them to the doctor.
The most common symptom of endometrial cancer is post-menopausal bleeding. The doctor will diagnose endometrial cancer by per-forming a biopsy of the endometrium. This biopsy can be performed in one of two ways. The first way is to perform a biopsy in the office with a soft plastic straw called a “pipelle” biopsy. Most of the time, this biopsy can be performed with minimal discomfort to the patient at the time of an office visit.
Sometimes an office biopsy either cannot be per-formed or does not result in a diagnosis. In that case, a diagnosis can be made with a D&C in the operating room. D&C stands for dilatation and curettage. In this procedure the surgeon will dilate, or open, the cervix in order to perform a curettage, or scraping, of the uterine cavity.
This procedure will allow the endometrium to be collected and sent to pathology for diagnosis. Sometimes a tool called hysteroscopy is also used to help direct the curettage. A fiber-optic scope is used to look inside the uterus so the surgeon can be sure the abnormal area of endometrium is correctly sampled.