Table of ContentsView AllTable of ContentsSelf Checks/At-Home TestingPhysical ExamImagingLabs and TestsSurgical BiopsyDifferential DiagnosesTumor Type and GradeStagesFrequently Asked QuestionsNext in Ovarian Cancer GuideOvarian Cancer
Table of ContentsView All
View All
Table of Contents
Self Checks/At-Home Testing
Physical Exam
Imaging
Labs and Tests
Surgical Biopsy
Differential Diagnoses
Tumor Type and Grade
Stages
Frequently Asked Questions
Next in Ovarian Cancer Guide
A number of tests and procedures may be used to diagnoseovarian cancer, including a pelvic exam; imaging tests, such as transvaginal ultrasound, CT, or MRI; and blood tests, such as CA-125. A biopsy is usually needed to determine whether a mass is malignant (cancerous) and to identify the type and subtype of the disease.
When a diagnosis is made, these results and further tests are used to define the stage of the disease, which will help determine thebest course of treatment.
There are no self-checks for ovarian cancer. Furthermore, at-home genetic tests cannot definitely determine yourrisk of developing the disease. It’s important to be familiar with thesigns and symptomsand to talk to your doctor if you have any risk factors for the disease.
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However, this check has limitations:
It’s important to note that a Pap smear alone (without a bimanual exam), is helpful in detecting cervical cancer but not ovarian cancer.
Imaging tests can help identify a small ovarian mass and further evaluate a mass that’s felt on exam.
Transvaginal Ultrasound
A pelvic ultrasound is a test that uses sound waves to create an image of the pelvic organs. It is usually the first test performed to evaluate an ovarian mass and does not cause radiation exposure.
The procedure can be done either abdominally (the probe is positioned on top of your skin) or transvaginally (the probe is inserted into the vagina to get closer to the ovary). The transvaginal method is better for defining ovarian masses, especially those that are small.
An ultrasound can provide an estimate of the size of a mass, as well as help to determine whether it’s a simple cyst, a complex cyst, or solid.
An ultrasound can also detect free fluid in the pelvis, which is often seen with advanced tumors.
Abdominal and/or Pelvic CT Scan
A computerized tomography (CT) scan uses a series of X-rays to create a picture of the abdomen or pelvis. It may be used to aid in the diagnosis, but is more often used in staging cancer. It is a good test to evaluate the lymph nodes, intestines, liver, and lungs (chest CT scan) for evidence ofmetastasis(spread of cancer).
A CT scan may identify:
Also,lymph nodesmay be described as enlarged. Enlarged lymph nodes are usually larger than 2 cm (around 1 inch) in diameter and may have areas of central necrosis (cell death) if cancer is present.
MRI
Magnetic resonance imaging (MRI) may be used in a way similar to a CT scan but does not involve radiation, making it a safer test during pregnancy. MRI tends to be better than CT at defining soft tissue abnormalities and may be used to clarify findings that were detected on other tests.
PET Scan
APET scanis a functional imaging test that measures tissue activity. This test looks for evidence of metastases (spread) anywhere in the body and is helpful in discriminating between scar tissue and cancer.
In addition to imaging studies and a physical exam, blood work can be helpful for assessing some aspects of ovarian cancer.
Blood Work for Tumor Marker Detection
Identifying tumor markers is not an effective way to screen for ovarian cancer, but it can be helpful during the diagnostic phase and for following the treatment response.
Other Blood Tests
Other blood tests you might have include complete blood count (CBC), LDH, alkaline phosphatase, and a sed rate or C-reactive protein test (which looks for inflammation).
Research has found that a combination ofred blood cell indices, red blood cell distribution width (RDW), andmean platelet volume(MPV) may be helpful in predicting which ovarian tumors are cancerous and which are not.RDW tends to be high andMPV lowwith ovarian cancer.
Ovarian Risk Index
A number of different risk of malignancy indices look at a combination of findings on tests and imaging to predict whether a problem could be ovarian cancer and if a biopsy is needed. While these may be helpful, the objective measures of estimating risk are more accurate when used along with the subjective assessment of an expert, such as a gynecological oncologist.
A biopsy (sample) of a suspicious growth is usually done via surgery.At times, a needle biopsy (in which a needle is inserted through the skin) may be considered, but it’s thought that if ovarian cancer is present, this could result in what’s known as seeding (the spread of the tumor).
A surgical biopsy can be done with laparoscopic surgery, in which a few small incisions are made in the abdomen and a probe with a camera and instruments are inserted. It can also be done with an open laparotomy, during which a traditional incision is made in the abdomen.
The biopsy is taken and sent to a pathologist to determine if it is cancerous, and if so, the type. Your biopsy report should describe the sample as either benign (non-cancerous) or malignant (non-cancerous).
A mass in the region of the ovary and fallopian tube that’s detected with an exam or an imaging test is referred to as anadnexal mass. A few possible causes (there are many) may include the following:
A biopsy is used to determine the type and grade of a tumor.
For advanced ovarian cancers, biopsies are usually taken from the lymph nodes, omentum (a fatty, carpet-like structure overlying the intestine), and often several areas of the peritoneum (the membranes that line the abdominal cavity). A surgeon will also remove or make note of any suspicious-looking nodules or other masses. If the cancer was mucinous, the appendix will be removed.
Washings may also be done, in which the surgeon injects saline into the abdomen and then withdraws the fluid to look for evidence of cancer cells.
After surgery, your surgeon will send any tissue that was removed to a pathologist. This may include your ovaries,fallopian tubes, uterus, and tissue and biopsies taken from other regions of your abdomen.
Type and subtype:Knowing the type and subtype of ovarian cancer can give information on the expected aggressiveness of a tumor and whether it is fast or slow-growing.
Tumor grade:This is a measure of the tumor’s aggressiveness.With endometrioid ovarian cancers, cancers are given a tumor grade between 1 and 3:
Serous tumors are given one of two ratings instead: low grade or high grade.
If a diagnosis of ovarian cancer is made, staging the tumor is critical in choosing the best treatment options.
Some of the information needed for staging may be gathered from imaging tests and a biopsy, and sometimes surgery (to remove the ovaries and often additional tissue) is needed to accurately stage cancer. Imaging tests and surgery can help determine if cancer has spread to lymph nodes or other regions of the body.
Ovarian cancer is staged using either simplified or full FIGO staging methods. Findings may also be defined as borderline ovarian cancer. Though the below mostly concerns your physician, it may be helpful as you work to understand what treatment options may be appropriate for you.
Borderline Ovarian Cancer
Borderline ovarian cancers are those that have low malignant potential. These are usually early stage tumors and usually do not grow back after surgery. These tumors may be given a stage if your surgeon is uncertain during surgery whether higher grade cancer is present, or if it appears there was spread of the tumor.
Simplified Staging
To get a broad picture of the differences between stages, these can be broken down into:
Full FIGO Staging
The full FIGO, named for the International Federation of Gynecology and Obstetrics, is a surgical staging system that uses Roman numerals for stages (to estimate the prognosis) and letters for substages (which help guide treatment options).
Ovarian cancer often has vague symptoms in the early stages, or none at all. When they do appear, the most common symptoms are bloating, pelvic and abdominal pain, difficulty with eating and feeling full, and feeling like you need to urinate frequently. Other less common symptoms include fatigue, back pain, pain during sex, and changes in the menstrual cycle.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Tests for Ovarian Cancer.MedlinePlus.CA-125 blood test (ovarian cancer).Qin YY, Wu YY, Xian XY, et al.Single and combined use of red cell distribution width, mean platelet volume, and cancer antigen 125 for differential diagnosis of ovarian cancer and benign ovarian tumors.J Ovarian Res.2018;11(1):10. doi:10.1186/s13048-018-0382-3Biggs WS, Marks ST.Diagnosis and Management of Adnexal Masses.Am Fam Physician; 93(8):676-81.American Cancer Society.Cancer staging.American Cancer Society.Ovarian Cancer Stages.American Cancer Society.Signs and symptoms of ovarian cancer.American Cancer Society.Ovarian cancer survival rates.Additional ReadingHenderson, J., Webber, E., and G. Sawaya.Screening for Ovarian Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.JAMA. 319(6):595-606.Qin, Y., Wu, Y., Xian, X. et al.Single and Combined use of Red Cell Distribution Width, Mean Platelet volume, and Cancer Antigen 125 for Differential Diagnosis of Ovarian Cancer and Benign Ovarian Tumors.Journal of Ovarian Research. 11(1):10.Soletormos, G., Duffy, M., Othman, S. et al.Clinical Use of Cancer Biomarkers in Epithelial Ovarian Cancer: Updated Guidelines From the European Group on Tumor Markers.International Journal of Gynecological Cancer. 26(1):43-51.National Cancer Institute. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ)—Health Professional Version. Updated 01/19/18.https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Tests for Ovarian Cancer.MedlinePlus.CA-125 blood test (ovarian cancer).Qin YY, Wu YY, Xian XY, et al.Single and combined use of red cell distribution width, mean platelet volume, and cancer antigen 125 for differential diagnosis of ovarian cancer and benign ovarian tumors.J Ovarian Res.2018;11(1):10. doi:10.1186/s13048-018-0382-3Biggs WS, Marks ST.Diagnosis and Management of Adnexal Masses.Am Fam Physician; 93(8):676-81.American Cancer Society.Cancer staging.American Cancer Society.Ovarian Cancer Stages.American Cancer Society.Signs and symptoms of ovarian cancer.American Cancer Society.Ovarian cancer survival rates.Additional ReadingHenderson, J., Webber, E., and G. Sawaya.Screening for Ovarian Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.JAMA. 319(6):595-606.Qin, Y., Wu, Y., Xian, X. et al.Single and Combined use of Red Cell Distribution Width, Mean Platelet volume, and Cancer Antigen 125 for Differential Diagnosis of Ovarian Cancer and Benign Ovarian Tumors.Journal of Ovarian Research. 11(1):10.Soletormos, G., Duffy, M., Othman, S. et al.Clinical Use of Cancer Biomarkers in Epithelial Ovarian Cancer: Updated Guidelines From the European Group on Tumor Markers.International Journal of Gynecological Cancer. 26(1):43-51.National Cancer Institute. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ)—Health Professional Version. Updated 01/19/18.https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Tests for Ovarian Cancer.MedlinePlus.CA-125 blood test (ovarian cancer).Qin YY, Wu YY, Xian XY, et al.Single and combined use of red cell distribution width, mean platelet volume, and cancer antigen 125 for differential diagnosis of ovarian cancer and benign ovarian tumors.J Ovarian Res.2018;11(1):10. doi:10.1186/s13048-018-0382-3Biggs WS, Marks ST.Diagnosis and Management of Adnexal Masses.Am Fam Physician; 93(8):676-81.American Cancer Society.Cancer staging.American Cancer Society.Ovarian Cancer Stages.American Cancer Society.Signs and symptoms of ovarian cancer.American Cancer Society.Ovarian cancer survival rates.
American Cancer Society.Tests for Ovarian Cancer.
MedlinePlus.CA-125 blood test (ovarian cancer).
Qin YY, Wu YY, Xian XY, et al.Single and combined use of red cell distribution width, mean platelet volume, and cancer antigen 125 for differential diagnosis of ovarian cancer and benign ovarian tumors.J Ovarian Res.2018;11(1):10. doi:10.1186/s13048-018-0382-3
Biggs WS, Marks ST.Diagnosis and Management of Adnexal Masses.Am Fam Physician; 93(8):676-81.
American Cancer Society.Cancer staging.
American Cancer Society.Ovarian Cancer Stages.
American Cancer Society.Signs and symptoms of ovarian cancer.
American Cancer Society.Ovarian cancer survival rates.
Henderson, J., Webber, E., and G. Sawaya.Screening for Ovarian Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.JAMA. 319(6):595-606.Qin, Y., Wu, Y., Xian, X. et al.Single and Combined use of Red Cell Distribution Width, Mean Platelet volume, and Cancer Antigen 125 for Differential Diagnosis of Ovarian Cancer and Benign Ovarian Tumors.Journal of Ovarian Research. 11(1):10.Soletormos, G., Duffy, M., Othman, S. et al.Clinical Use of Cancer Biomarkers in Epithelial Ovarian Cancer: Updated Guidelines From the European Group on Tumor Markers.International Journal of Gynecological Cancer. 26(1):43-51.National Cancer Institute. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ)—Health Professional Version. Updated 01/19/18.https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq
Henderson, J., Webber, E., and G. Sawaya.Screening for Ovarian Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.JAMA. 319(6):595-606.
Qin, Y., Wu, Y., Xian, X. et al.Single and Combined use of Red Cell Distribution Width, Mean Platelet volume, and Cancer Antigen 125 for Differential Diagnosis of Ovarian Cancer and Benign Ovarian Tumors.Journal of Ovarian Research. 11(1):10.
Soletormos, G., Duffy, M., Othman, S. et al.Clinical Use of Cancer Biomarkers in Epithelial Ovarian Cancer: Updated Guidelines From the European Group on Tumor Markers.International Journal of Gynecological Cancer. 26(1):43-51.
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