Diagnosis of endometrial cancer can only be obtained by biopsy. A pap smear is not sufficient screening for endometrial cancer. An endometrial biopsy should be performed in any woman experiencing post-menopausal bleeding. Most endometrial biopsies can be safely and painlessly performed in the doctor’s office.
In the rare instance when an office biopsy does not result in definitive diagnosis, a dilation and curettage can be performed in the operating room. This is an outpatient procedure and will typically take less than 30 minutes to complete. The pathologist will look at the cells under a microscope to make a definitive diagnosis.
Sometimes the pathologist will diagnose a condition called atypical endometrial hyperplasia, in which the cells appear to be pre-cancerous. Studies have shown that even with this specific diagnosis, cancer may be diagnosed in up to 40-50% of patients at the time of surgical treatment. It is for this reason that all women with pre-cancerous and cancerous lesions should be referred to a gynecologic oncologist.
What Is Endometrial Hyperplasia?
Endometrial hyperplasia is the excessive proliferation of endometrial cells. It most commonly results from high levels of estrogen with insufficient levels of the hormones that counteract estrogen.