Testing for Ovarian Cancer
Ovarian cancer is no longer considered just one type of cancer. There are several subtypes of ovarian cancer, and identifying those types requires careful evaluation by highly specialized pathologists. Making the correct diagnosis is key to tailoring treatment to your specific type of cancer. That's why it is important to select a cancer center with a pathology team dedicated to evaluating ovarian cancer of all kinds, like the Dana-Farber Brigham Cancer Center, affiliated with the Susan F. Smith Center for Women's Cancers.
Our Pathology Division is one of the few clinical services globally with a team of pathologists and researchers who focus entirely on gynecologic cancers, with thousands of diagnoses each year. The Pathology Division houses the largest team of gynecology specialists in the world and guides research teams across the country on how ovarian tumors develop and how they can be prevented.
Our pathologists and researchers are skilled at diagnosing common and rare ovarian cancers, including:
- Epithelial: This is the most common type of ovarian cancer, which starts in the epithelial tissue, the lining on the outside of the ovary or in the fallopian tube. Epithelial ovarian cancer also includes primary peritoneal cancer and fallopian tube cancer. This type of ovarian cancer is divided into serous (high grade and low grade), mucinous, endometrioid (high grade and low grade), clear cell, transitional, and undifferentiated types. Ovarian carcinosarcoma is another rare type of ovarian cancer that we treat.
- Germ cell: Germ cell tumors begin in the egg-producing cells. The main subtypes are teratoma, dysgerminoma, endodermal sinus tumor, and choriocarcinoma.
- Sex cord stromal: These rare tumors grow in the connective tissue that holds the ovary together and makes estrogen and progesterone. Sub-types include granulosa, granulosa-theca, and Sertoli-Leydig cell tumors.
Tests to Diagnose Ovarian Cancer
After our doctors carefully review your medical history and your familial risk of developing ovarian cancer, and complete a pelvic exam, they will conduct a combination of biopsies and imaging tests. The results from these tests are reviewed regularly by a dedicated gynecology team of surgeons, medical oncologists, and radiation oncologists at a weekly tumor board meeting. This team will determine the best course of treatment specific to your type of ovarian cancer.
There is no standard screening test to identify ovarian cancer. Diagnosis of ovarian cancer begins with a pelvic exam with your doctor, which can be helpful in identifying a mass on either side of the uterus.
Recommended Tests to Determine the Presence of Ovarian Cancer
- Transvaginal ultrasound: a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the vagina, uterus, fallopian tubes, and bladder. The wave echoes form a picture of body tissues called a sonogram.
- Blood test: a test to measure a substance in the blood called CA-125 (a tumor marker that is often found to be elevated in the blood of women with ovarian cancer). This test is used to monitor the progress of treatment.
- CT Scan and Surgery: When the presence of ovarian cancer is detected, a CT scan or another radiologic procedure is performed to determine the extent of the disease. If the disease appears resectable (able to be removed through surgery), surgery is performed to make a definitive diagnosis and remove the tumor. If the disease does not appear to be resectable, a biopsy is performed to make a definitive diagnosis and determine the course of treatment.