Tests and diagnosisBy Mayo Clinic staff
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Diagnosing ovarian cancer
Tests and procedures used to diagnose ovarian cancer include:
Pelvic examination. During a pelvic exam, your doctor carefully inspects the outer exposed part of your genitals (vulva), and then inserts two fingers of one hand into your vagina and simultaneously presses the other hand on your abdomen to feel your uterus and ovaries.
He or she also inserts a device called a speculum into your vagina. The speculum opens your vagina so that your doctor can visually check your vagina and cervix for abnormalities.
Ultrasound. Ultrasound uses high-frequency sound waves to produce images of the inside of the body. An ultrasound helps your doctor investigate the size, shape and configuration of your ovaries.
To create a picture of your ovaries, your doctor may insert an ultrasound probe into your vagina. This procedure is called transvaginal ultrasound. Ultrasound imaging can create pictures of the structures near your ovaries, such as your uterus.
Surgery to remove samples of tissue for testing. If other tests suggest you may have ovarian cancer, your doctor may recommend surgery to confirm the diagnosis.
During surgery, a gynecologic oncologist makes an incision in your abdomen to explore your abdominal cavity and determine whether cancer is present. In some cases, the surgeon may use several small incisions and insert special surgical tools to perform minimally invasive surgery or robotic surgery.
The surgeon may collect samples of abdominal fluid and remove an ovary or other tissue for examination by a pathologist. If cancer is discovered, the surgeon may immediately begin surgery to remove as much of the cancer as possible.
CA 125 blood test. CA 125 is a protein found on the surface of ovarian cancer cells and some healthy tissue. Many women with ovarian cancer have abnormally high levels of CA 125 in their blood.
However, a number of noncancerous conditions also cause elevated CA 125 levels, and many women with early-stage ovarian cancer have normal CA 125 levels. For this reason, a CA 125 test isn't usually used to diagnose or to screen for ovarian cancer, but it may be used after diagnosis to monitor how your treatment is progressing.
Staging ovarian cancer
Doctors use the results of your surgery to help determine the extent — or stage — of your cancer. Your doctor may also use information from imaging tests, such as computerized tomography (CT). Your cancer's stage helps determine your prognosis and your treatment options.
Stages of ovarian cancer include:
- Stage I. Ovarian cancer is confined to one or both ovaries.
- Stage II. Ovarian cancer has spread to other locations in the pelvis, such as the uterus or fallopian tubes.
- Stage III. Ovarian cancer has spread beyond the pelvis or to the lymph nodes within the abdomen.
- Stage IV. Ovarian cancer has spread to organs beyond the abdomen, such as the liver or the lungs.
- Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-0-323-06986-1&eid=4-u1.0-B978-0-323-06986-1..C2009-0-48752-X--TOP. Accessed Sept. 21, 2012.
- Ovarian cancer including fallopian tube cancer and primary peritoneal cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Sept. 21, 2012.
- What you need to know about ovarian cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/ovary. Accessed Sept. 21, 2012.
- Hoffman BL, et al. Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com/resourceTOC.aspx?resourceID=768. Accessed Sept. 21, 2012.