Uterine Cancer Biopsy?

[samantha1958]

I am 47 years old with 3 kids. My weight is perfect and I have no health issues. My yearly pap tests, normal. However I have been having mid cyle spotting once in the blue moon and had a biopsy done 4.5 years ago that came back negative for cancer or precancer cells. I still get this spotting,not often, should I have another biopsy done since the last one was 4.5 years ago? How fast does uterine cancer grow?

[Machelle Seibel, MD]

A. Uterine cancer grows slowly and it is believed to take 10 years for precancer to turn into cancer.  But one never knows when the precancer starts.  In general, if a person hasn’t had the lining of her uterus checked in two years or more and bleeding continues, I would suggest rechecking the lining to be sure nothing has changed.

People who have this type of long bleeding sometimes also have a buildup of the uterine lining called a polyp.  Sometimes an office test called an endometrial biopsy can help figure out the problem. The test involves placing a thin instrument into the uterus and scraping out a few cells to be looked at under the microscope.  Sometimes a minor operation called hysteroscopy is done in which a thin telescope is placed into the uterus to look at the lining and see if there is a problem.  This can sometimes be done in the office and sometimes it is done in the operating room with anesthesia. It usually takes at most half an hour. Sometimes a D&C (dilation and curettage) is done.  This procedure involves stretching slightly the opening of the uterus and scraping the lining in a more complete way to increase the chances that nothing is missed. It is done in the operating room and usually takes only a few minutes. Depending on the finding, your doctor might want to prescribe you hormones for a short while to regulate the bleeding.

Machelle M. Seibel, MD