Womb biopsy

The only way to definitely diagnose womb cancer is to take a sample of the tissue lining the womb. This is called an endometrial biopsy. Your doctor sends the sample to the lab. This is where a pathologist checks it for abnormal or cancerous cells.

There are different ways to take a biopsy of the womb lining.

Aspiration biopsy

To have this test you lie on your back on a couch with your knees up and feet apart. You'll need to remove your underwear, but you will have a sheet to cover yourself with. Your doctor or nurse gently opens your vagina with a speculum. This is just the same as when you have a cervical screening test (smear test).

Your doctor puts a long thin tube into the womb through your vagina. With gentle suction, they draw some of the cells lining the womb into the tube. They then remove the tube and the speculum. You can get up from the couch and get dressed.

Most women have this procedure while they are awake. It should only take a few minutes. You can normally go home straight afterwards.

Your doctor sends the sample of cells to the lab. A pathologist checks them carefully under a microscope.

You may have period type pains (cramping) during or after this test. Mild painkillers such as paracetamol, should help to control any pain. You may have some vaginal bleeding for a couple of days afterwards.

Hysteroscopy

This test uses a very thin telescope called a hysteroscope. Your doctor uses it to look into your womb and take a biopsy. It takes about 10 minutes.

Before you have the test your doctor should tell you about what the test involves and tell you about the different ways you can have it. You can have a local, general or spinal anaesthetic. If you have a local anaesthetic you have the test as an outpatient. This means you will be in and out of the hospital within a couple of hours. If you have a general or spinal anaesthetic you have it as a day patient. This means you will be on a day ward and be in hospital for most of the day.

Some people find the test painful. Talk to your doctor about it beforehand. You may have more pain if:

• you faint because of pain when you have periods
• you find vaginal examination painful
• having cervical smears is painful
• you have had a traumatic experience that might make it difficult for you

If you are having the test as an outpatient without a general anaesthetic you may be advised to take painkillers an hour before you have the test. Tell the doctor or nurse if you are in pain during the test so they can stop and give you something for it.

To have the test you need to remove any clothes from below your waist. You may be asked to change into a hospital gown. You lie on a couch with your legs held in supports. You will have a sheet to cover your lower half. 

Your doctor gently puts a speculum into your vagina to keep it open. They put antiseptic around the area to clean it. Then your doctor passes the hysteroscope through your cervix into the womb.

Your doctor examines your womb and takes a sample of the lining. They send this to the lab to check for cancer cells.

After this test you might have some cramping pains, but mild painkillers should help eg paracetamol or ibruprofen. You may also have some vaginal bleeding which can last up to 7 to 10 days. Contact your doctor or go to A&E if you have:

• heavy bleeding.
• pain despite taking painkillers 

Getting your results

You usually get the results within 2 weeks. The doctor who arranged the biopsy will give them to you.

Waiting for test results can be worrying. It may help to talk to a close friend or relative about how you feel.