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Can a endometrial biopsy detect ovarian cancer?
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Can a endometrial biopsy detect ovarian cancer?

Hi, I found this Website to be very helpful, and the people who give advice, are just as informative about ovarian cancer, if not more so, than the information that we've been told by several doctors.  To try and sum up my mother's on going problem, 7 months ago, a transvaginal test showed that my 82 year old mom had a complex mass on her right ovary, which measured approximately 5.7 cm at the time.  Being that she has a heart problem, her CA-125 was 5.5, and she had no symptoms, we decided (along with her gynecologist) just to "watch it".  After 3 ultrasounds, 4 transvaginal tests, a CT scan, and an MRI, her doctor still doesn't have any strong indications of whether the mass is malignant or not.  As of now, the mass's largest measurement seems to be around 6.5 cms, although some of the other measurements appear to be smaller?  (According to the gynecologist, every time a technician measures it, it could be from different angles, which makes it hard to tell whether the mass has actually grown.)  Recently, after taking another CA-125, it came back 5.9, and now the gynecologist has my mom scheduled for a endometrial biopsy.  However, from what I've read, an endometrial biopsy is not going to tell us whether my mom has ovarian cancer, is that correct?  We also asked the doctor about performing a PET scan, but for some reason, he said no to that.  Although we completely understand that to remove the ovary is the safest, and best solution, because of my mother's heart problem, and her having to take care of me, (I'm a 46 year old quadriplegic) surgery is a last resort for us.  I pray that someone out there will give us some advice, and are we being extremely foolish by continuing to watch the mass instead of removing it immediately? Thank you in advance for your help, may God bless all of you, and keep you healthy for many years to come.

Leslie
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You are correct that nothing but surgical removal of the cyst to perform a biopsy would tell you if it is cancer.  There is no test for ovarian cancer.  I don't understand why the doctor wants to do an endometrial biopsy unless he is just wanting to do something for something's sake.  I think you should try to get an appointment with a GYN Oncologist for further testing.  If you've read a lot of these posts, you've seen that advice given quite a bit.  A gyn/onc is trained up to three years longer than a regular gyn, and is more experienced in issues involving cancer diagnoses.  Yes, surgery would be the last option, but it might be the best option at this point.  Not knowing your personal situation, would it be possible to get someone to help take care of your needs for a little while without being a financial burden?  How does your mom feel, physicaly?  Is she tired and worn out more than usual, or does she feel full quickly when she eats?  Her CA125 is not alarming, but then again, it is not always accurate for all women.  Besides that, the cyst does not seem to be resolving itself, and it's been 7 months.  I think most doctors would agree that it's time it came out, which is why a second opinion may be necessary.  Your situation is different, though, so maybe her doctor is trying to be a thorough as he can.  But if it does come down to surgery, she will be in better hands if a gyn/onc performs it.

In the interim, would you be able to talk to a social worker at the medical facility where your mom receives care about trying to find a solution to getting someone in to help out should your mom have surgery?  If you have that worked out, your mom might feel more at ease about getting this thing removed.  Your needs are very important, too, so that is a very essential part of this whole situation.  

Best wishes to you and your mom, and please let us know as things progress.

Gail    
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Thank you for replying to my post.  Actually, this is the 3rd opinion that my mom has had, although none of them were from a gynecological oncologist.  Her regular gynecologist originally said that the mass didn't appear to be cancerous, although they recommended a complete hysterectomy to be safe.  The 2nd opinion was from the gynecologist that she's currently going to now, and although he also didn't think the mass was malignant, he sent my mom to a Pittsburgh hospital who specializes in women's health for further testing, and to get their opinion as well.  However, they also said being that the mass possesses solid and fluid components, the safest thing would be to remove it.  As far as the endometrial biopsy, there was some fluid in her endometrial cavity, and although there hasn't been any change in it, I'm assuming that the biopsy is to find out if there's something going on besides with just the ovary itself.  Her current gynecologist is trying every way possible not to do surgery unless it's absolutely life threatening, but we can't seem to get any kind of a substantial answer from the test results.  However, should the endometrial biopsy come back positive, there will be no decision to make, surgery will be absolutely necessary.  Mom is having the biopsy done this week, so I will post what the results are once we find out.  However, would you happen to know what the percentage rate increases to for a woman of my mom's age?  Thank you again for taking the time to respond to my concerns.

Leslie
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There are lots of statistics out there that in my opinion, tell you nothing.  I don't like them because each one of us responds differently, and are more than just a number in the "good outcome" or "bad outcome" column.  But, I also realize they can help people understand certain trends.  According to the National Cancer Institute, women of your mother's age make up about 18% of the cases of ovarian cancer.  Around 22,000 women will be diagnosed with ovarian cancer in a given year.  There are also statistics out there for survival rates according to stage at diagnosis, but let's not cross that bridge until we get there.

Sending positive thoughts to you and mom for a good result this week.  
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I just wanted to update you (and anyone else who may be reading this thread) about the outcome of my Mom's endometrial biopsy.  Although the doctor wasn't able to get much tissue, (being that her uterus was so thin) what he did get, came back negative, and the fluid in her uterus was just some benign mucus.  (I later found out, the reason why the doctor did an endometrial biopsy, is because whenever my Mom had a transvaginal test at Magee Women's Hospital in Pittsburgh, their doctor was just as concerned about the fluid in her uterus, as the complex mass in her ovary.)  As of now, my Mom's doctor feels that we should just continue to watch her ovary, and see if there are any changes within the next 3 months.  Because of her age, and heart problem, he feels if there's very little change in the future, it's not worth the risk of putting her through surgery just as a precaution.  However, I was wondering if a PET Scan would be helpful to find out whether the mass is malignant or not?  Thank you for your time, and concern, and I will continue to post the outcome of my Mom's prognosis for anyone out there who may be "high risk" for surgery.  I found this forum to be very informative and comforting, and I wish all of you a very long, and healthy life.

Leslie
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