Endometrial cancer is a disease in which malignant (cancer)
cells form in the tissues of the endometrium.
The endometrium is the
lining of the uterus, a hollow, muscular organ in a woman’s
pelvis. The uterus is where a
fetus grows. In most nonpregnant
women, the uterus is about 3 inches long. The lower, narrow end of the uterus is the cervix, which leads to the vagina.
Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.
Cancer of the endometrium
is different from cancer of the muscle of the uterus, which is called
sarcoma of the uterus. See the
PDQ summary on Uterine Sarcoma Treatment for more information.
Taking tamoxifen for breast cancer or taking estrogen alone
(without progesterone) can affect the risk of developing endometrial cancer.
Endometrial cancer may develop in breast cancer patients who have
been treated with tamoxifen. A
patient taking this drug should have a pelvic exam every year and report
any vaginal bleeding (other than
menstrual bleeding) as soon as
possible. Women taking estrogen (a
hormone that can affect the growth
of some cancers) alone have an increased risk of developing endometrial cancer.
Taking estrogen in combination with progesterone (another hormone) does not increase a
woman’s risk of this cancer.
Possible signs of endometrial cancer include unusual vaginal
discharge or pain in the pelvis.
These and other symptoms may be caused by endometrial cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
Tests that examine the endometrium are used to detect (find) and diagnose
Because endometrial cancer begins inside the uterus, it does not
usually show up in the results of a Pap
test. For this reason, a sample of endometrial
tissue must be removed and examined
under a microscope to look for cancer cells. One of the following procedures may be
Endometrial biopsy: The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologist views the tissue under a microscope to look for cancer cells.
Dilatation and curettage: Surgery to remove samples of tissue or the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. Tissue samples may be taken and checked under a microscope for signs of disease. This procedure is also called a D&C.
Dilatation and curettage (D and C). A speculum is inserted into the vagina to widen it in order to look at the cervix (first panel). A dilator is used to widen the cervix (middle panel). A curette is put through the cervix into the uterus to scrape out abnormal tissue (last panel).
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
The stage of the cancer (whether it is in the endometrium only, involves the whole uterus, or has spread to other places in the body).
How the cancer cells look under a microscope.
Whether the cancer cells are affected by progesterone.