Biopsy of the womb lining

If the ultrasound shows any thickened or abnormal areas in the womb lining, your doctor may suggest a biopsy. A biopsy is a sample of cells or tissue taken from the lining of your womb (endometrial biopsy).

A doctor will look at the sample under a microscope. If cancer cells are present, the biopsy results usually also show what type and grade of womb cancer it is. The doctor will also look for certain genetic changes (variants) in the womb cancer cells. Checking for these changes in the cells can help the doctor know how the cancer might behave. The results can also tell the doctor if the cancer may be linked to a genetic condition.

Biopsies are taken in different ways:

Aspiration biopsy
Outpatient hysteroscopy
Hysteroscopy dilatation and curettage (D&C).

Related pages

Biopsy

Aspiration biopsy

An aspiration biopsy is usually done during an outpatient clinic appointment. You may not need an anaesthetic. Or it may be done as a hospital visit, where you are given a local or general anaesthetic

Before the procedure, you will either put on a gown or undress your lower half. Once you are on the couch, you will have a sheet to cover you from the waist down. The position you are in for an aspiration biopsy is similar to an internal examination. You lay on your back, with your legs slightly apart. Your doctor or nurse gently puts an instrument called a speculum into the vagina to keep it open. They carefully pass a fine tube through the cervix into the womb.

They then draw some cells from the womb lining into the tube, using gentle suction. You might feel some period-like cramps while it is being done, but this usually stops after a few minutes. If you were awake during the biopsy, you can usually go home straight away.

Having an aspiration biopsy

An image of a female’s lower abdomen, pelvis and upper thigh from the side. It shows the bladder, womb, back passage (rectum), vagina, cervix and the womb. An instrument called a speculum is shown sitting in the vagina — Image: The image shows a female’s lower abdomen, pelvis and upper thigh from the side. The person is lying on their back with their knees raised. The position of the bladder, womb and back passage (rectum) are shown in the pelvis. The bladder is closest to the front of the pelvis. A short narrow tube runs from the bladder to a small opening on the outside of the body between the legs. The back passage is shown closest to the back of the pelvis. This leaves the body through a small opening closer to the back between the legs. A third opening is shown between these two openings. This is the vagina. The vagina leads from the opening into the pelvis between the bladder and back passage. At the inner end of the vagina is the cervix and behind the cervix is the womb. An instrument called a speculum is shown sitting in the vagina. The speculum has two handles that are outside the body between the upper thighs. A screw connects the two handles so they can be adjusted closer or further apart. Inside the vagina, two long, rounded parts of the speculum are shown. These are holding the walls of the vagina apart. The speculum is slightly see-through as though it is made of clear plastic.

Outpatient hysteroscopy

A hysteroscopy is a test to look inside the womb. It is usually done during an outpatient clinic appointment. The doctor or nurse uses a thin, flexible tube with a camera and a light on the end (hysteroscope). They gently pass it through the vagina and cervix, into the womb.

Before the hysteroscopy, they may put a speculum into the vagina first and inject a small amount of anaesthetic into the cervix. This helps open up the cervix to allow the hysteroscope to pass into the womb. Your doctor or nurse may advise you to take some painkillers an hour before the test.

During the hysteroscopy, pictures of the inside of the womb show up on a screen. The doctor or nurse puts some clear fluid or air into the hysteroscope to allow them to get a better picture. They will take a sample of tissue (biopsy) from the womb lining.

This test can be uncomfortable, and a small number of people find it painful. If you are worried, talk to your doctor about what they can do to make it as comfortable as possible. Some people choose to have it done under a general anaesthetic.

After the test, you will have some vaginal bleeding and period-like pain for a couple of days. The nurse may suggest you use pads rather than tampons to help prevent any infection. Taking painkillers, such as ibuprofen, can help. Check with your doctor which painkillers are suitable for you.

The nurse will explain anything you need to be aware of after your biopsy. Check with the nurse if you can go back to your usual activities, such as work or driving. The nurse may advise you to avoid having sex or going swimming until any bleeding settles.

Before you go home, the nurse will also explain any follow-up care and tell you who to contact if you have questions or concerns after the test.

Hysteroscopy dilatation and curettage (D&C)

A biopsy may be taken during a procedure called a D&C. This test will usually be done in a day surgery unit and you will be given a general anaesthetic.

The surgeon gently opens up the cervix and uses a hysteroscope to look inside the womb. They then use a small instrument, called a curette, to carefully remove tissue from the womb lining. Afterwards, you may have vaginal bleeding and period-like pain for a couple of days. The nurse may suggest you use pads rather than tampons to help prevent any infection. Taking painkillers, such as ibuprofen, can help. Check with your doctor which painkillers are suitable for you.

After the biopsy

After the biopsy, you may have some light vaginal bleeding and mild period-like pain for a couple of days. The nurse may suggest you use pads rather than tampons to help prevent any infection. Taking painkillers, such as ibuprofen, can help. Check with your doctor which painkillers are suitable for you.

The nurse will explain anything you need to be aware of after your biopsy. Check with the nurse if you can go back to your usual activities, such as work or driving. The nurse may advise you to avoid having sex or going swimming until any bleeding settles. Make sure you have all the information you need, and ask who you can call if you have questions when you get home.

Waiting for test results

Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results to be ready. You may find it helpful to talk with your partner, your family or a close friend. Your specialist nurse or a support organisation can also provide support. Or you can talk to one of our cancer support specialists on 0808 808 00 00 (7 days a week, 8am to 8pm).

Related pages

Cancer tests and waiting for results

Booklets and resources

References

Below is a sample of the sources used in our womb cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk

Oaknin, A. et al. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology, Volume 33, Issue 9, 860 - 877
https://www.esmo.org/guidelines/guidelines-by-topic/esmo-clinical-practice-guidelines-gynaecological-cancers/endometrial-cancer (accessed January 2024).

Berek JS, Matias-Guiu X, Creutzberg C, et al. FIGO staging of endometrial cancer: 2023. Int J Gynecol Obstet. 2023; 162: 383-394. doi:10.1002/ijgo.14923 (accessed January 2024).

Suspected cancer: recognition and referral. NICE guideline [NG12] Published: 23 June 2015 Last updated: 02 October 2023 Overview | Suspected cancer: recognition and referral | Guidance | NICE (accessed January 2024).

Cancer Information Development team

Author

Miss Eva Myriokefalitaki

Reviewer

Consultant Gynaecological Oncology Surgeon

The Christie Hospital, Manchester

Dr Alexandra Taylor

Reviewer

Consultant Clinical Oncologist

Royal Marsden Hospital, London

Date reviewed

Reviewed: 01 March 2025

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Next review: 01 March 2028

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