When is endometrial biopsy recommended for womb cancer?

The endometrium is the inner lining of the womb. During an endometrial biopsy, a clinician passes a narrow instrument through the cervix to collect a small tissue sample. A pathologist examines it for changes such as overgrowth, atypical cells, or cancer. The result can help guide whether further assessment or treatment is needed. A biopsy may be suggested for bleeding after menopause, bleeding between periods, unusually heavy bleeding, or a thickened or irregular lining on imaging. Those symptoms have several possible causes and do not by themselves establish womb cancer.

Tell the clinician about pregnancy or a possibility of pregnancy, pelvic infection, bleeding disorders, allergies, and medicines that affect clotting. Ask whether pain relief is suitable and whether the sample can be taken during the planned visit. Afterward, use the recommended sanitary protection and follow advice about intercourse, bathing, and activity. Ask when the pathology result is expected and how it will be explained.

Contact the service for heavy or persistent bleeding, increasing pelvic pain, fever, chills, dizziness, or discharge with an unpleasant smell after the biopsy. Seek urgent help for severe pain, fainting, or bleeding that makes you feel weak. Before the appointment, prompt assessment is also appropriate for new bleeding after menopause or bleeding that is becoming difficult to manage.

What finding led to the biopsy recommendation? Could an ultrasound or hysteroscopy add useful information? How will pain be managed? What will the possible results mean? If the sample is insufficient, what would happen next?