Biopsy for womb cancer
Biopsy of the womb lining
If an ultrasound showed any abnormal areas in the womb lining, your doctor may suggest having a biopsy. This is called an endometrial biopsy and it involves taking a sample of cells or tissue from your womb lining. A doctor will then look at the sample under a microscope. If there are cancer cells present, the biopsy results usually show what type of womb cancer it is. Biopsies can be taken in different ways, including by aspiration or during a hysteroscopy.
Aspiration biopsy
This can often be done at your clinic appointment. You do not usually need an anaesthetic. But some people may have it at another time, with a local or general anaesthetic. 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 they usually wear off in a few minutes. After the test, you may have light bleeding and some mild period-like discomfort for a couple of days.
Outpatient hysteroscopy
You can have this test in an outpatient clinic. Your doctor or nurse uses a thin, flexible tube with a light on the end (hysteroscope). They gently pass it through the vagina and cervix, into the womb.
They may put a speculum into the vagina first and inject a small amount of anaesthetic into the cervix. This helps open the cervix a little and allows the hysteroscope 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 may be uncomfortable, and a small number of people may find it painful. If you are worried about the test, talk to your doctor about what they can do to make it as comfortable as possible. Some people may choose to have it done under a general anaesthetic.
After the test, you will have some vaginal bleeding and period-like cramps for a couple of days. Taking painkillers such as ibuprofen, can help with cramps. You can check with your doctor that these drugs are suitable for you.
Hysteroscopy dilatation and curettage (D&C)
You have this test under a general anaesthetic. It is usually done as an outpatient. The surgeon gently stretches (dilates) the cervix to open it and uses a hysteroscope to examine the womb. They then use a small instrument, called a curette, to carefully remove tissue from the womb lining. Afterwards, you may have period-like pains and some vaginal bleeding for a couple of days.
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 of your tests 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. You may find it helpful to talk to one of our cancer support specialists on 0808 808 00 00 (7 days a week, 8am to 8pm).
About our information
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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 cancerinformationteam@macmillan.org.uk
Concin et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. International Journal of Clinical Oncology. 2021. Available from www.pubmed.ncbi.nlm.nih.gov/33397713/
Royal College of Radiotherapy: Clinical Oncology. Radiotherapy dose fractionation, third edition. 2019. Available from www.rcr.ac.uk/publication/radiotherapy-dose-fractionation-third-edition
Sundar et al. BGCS uterine cancer guidelines: Recommendations for practice. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017. Available from www.bgcs.org.uk/wp-content/uploads/2019/05/BGCSEndometrial-Guidelines-2017.pdf
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
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